Comparison of Carbamazepine Alone and in Combination with Gabapentin as Medical Therapy to Control Pain Associated with Trigeminal Neuralgia

Objective: To investigate mean pain scores in patients of trigeminal neuralgia treated with Carbamazepine alone and in patients given combination therapy of Carbamazepine with Gabapentin after 4 weeks of starting therapy. Materials and Methods: A prospective clinical study was undertaken at the Department of Oral and Maxillofacial Surgery, Armed Forces Institute of Dentistry, Rawalpindi from July 2019 to March 2020. The first group received 100 mg of Carbamazepine twice daily and the second group received 100mg of Carbamazepine along with 300mg of Gabapentin twice daily. The patient was instructed to grade the intensity of pain on the Visual Analogue Scale (VAS) every week for four weeks after initiation of therapy. Mean pain scores for the week were calculated and compared. Results: A total of 80 respondents were recruited with a mean age and standard deviation was 48.69 ± 11.8 years. A comparison of the mean VAS score of 3rd week in both groups revealed that there was a significant difference (p<0.001). Similarly, by week four, the difference between VAS scores of Groups A and B differed significantly (p=0.007). Age and gender did not significantly impact the postoperative VAS pain score at four weeks of follow-up. Conclusion: The combination of Carbamazepine with Gabapentin resulted in better pain control in patients with trigeminal neuralgia as compared to Carbamazepine. Mean VAS score after 4th week in both groups Group A (Carbamazepine alone), and Group B (Carbamazepine plus Gabapentin), it was found that there was a significant difference between both groups and a significantly lower mean pain score was found in Group B as compared to Group A.