Preventive treatments in trigeminal neuralgia (adapted from Bendtsen et al41)
| Drug | Initiating dose | Titration* | Dose range | Frequency | Tapering† | Specific side effects |
| Carbamazepine | 200 mg | 200 mg every 3 days | 200–1200 mg | Two to four times per day | 200 mg every 7 days | Dizziness, drowsiness, fatigue, ataxia, diplopia, nausea, cognitive slowing, hyponatraemia leucopenia, thrombocytopenia, skin reactions, abnormal liver function tests |
| Oxcarbazepine | 300 mg | 300 mg every 3 days | 300–1800 mg | Four times per day | 300 mg every 7 days | Dizziness, drowsiness, fatigue, nausea, ataxia, hyponatraemia, skin reaction |
| Lamotrigine | 25 mg | 25 mg for 2 weeks, 50 mg for 1 week, then increase by 50 mg every week | 25–400 mg | Two times per day | 50 mg every 7 days | Dizziness, drowsiness, fatigue, headache, gastrointestinal symptoms, irritability, sleep disorders, tremor, cognitive slowing, rash |
| Gabapentin | 300 mg | 300 mg every 3 days | 300–3600 mg | Three times per day | 300 mg every 7 days | Dizziness, confusion, fatigue, ataxia, increased risk of infection, gastrointestinal symptoms, weight gain; use cautiously with opioids |
| Pregabalin | 150 mg | 150 mg every 7 days | 150–600 mg | Two times per day | 100 mg every 7 days | Dizziness, confusion, ataxia, increased risk of infection, gastrointestinal symptoms, weight gain |
| Baclofen | 15 mg | 15 mg every 7 days | 15–90 mg | Three times per day | 15 mg every 7 days | Confusion, dizziness, drowsiness, gastrointestinal symptoms, euphoria, hallucinations |
| Botulinum toxin type A | 25–195 units | NA | 25–195 units | Every 12 weeks | NA | Transient facial asymmetry, transient bruising at injection site, transient drooling and difficulty chewing |
*The doses can be increased at a slower rate to improve tolerability; the doses are increased until the pain is well controlled, significant side effects intervene or the maximum dose is achieved.
†The doses can be reduced more gradually and in smaller decrements; the dose is reduced to either the minimum required to control the pain or allow cessation of drug without recurrence of pain.
NA, not applicable.