a Department of Neurology and Psychiatry , University Sapienza , Roma , Italy.
Expert Rev Neurother. 2017 Oct;17(10):1003-1011. doi: 10.1080/14737175.2017.1370375. Epub 2017 Sep 4.
Unique among the different neuropathic pain conditions, trigeminal neuralgia frequently has an excellent response to some selected drugs, which, on the other hand, often entail disabling side effects. Physicians should be therefore acquainted with the management of these drugs and the few alternative options. Areas covered: This article, based on a systematic literature review, describes the pharmacological options, and indicates the future perspectives for treating trigeminal neuralgia. The article therefore provides current, evidence-based knowledge about the pharmacological treatment of trigeminal neuralgia, and suggests a practical approach to the various drugs, including starting dose, titration and side effects. Expert commentary: Carbamazepine and oxcarbazepine are the reference standard drugs for treating patients with trigeminal neuralgia. They are effective in most patients. The undesired effects however cause withdrawal from treatment or a dosage reduction to an insufficient level in many patients. Sodium channel blockers selective for the sodium channel 1.7 (Nav1.7) receptor, currently under development, might be an alternative, better-tolerated pharmacological option in the next future.
在不同的神经性疼痛疾病中，三叉神经痛是一种独特的疾病，经常对一些特定的药物有极好的反应，但另一方面，这些药物往往会带来致残的副作用。因此，医生应该了解这些药物的管理以及为数不多的替代选择。 涵盖领域：本文基于系统的文献回顾，描述了药理学选择，并指出了治疗三叉神经痛的未来前景。因此，本文提供了三叉神经痛的药理学治疗的最新循证知识，并为各种药物提供了一种实用的方法，包括起始剂量、滴定和副作用。 专家评论：卡马西平和奥卡西平是治疗三叉神经痛患者的标准药物。它们对大多数患者有效。然而，不良影响导致许多患者停药或减至不足以治疗的剂量。目前正在开发的钠离子通道 1.7（Nav1.7）受体选择性钠离子通道阻滞剂，可能是未来一种更耐受的替代药理学选择。
