Lappichetpaiboon Pramot, Tiamkao Somsak, Ruangsri Supanigar, Paphangkorakit Jarin, Pitiphat Waranuch, Jorns Teekayu P
Department of Oral Biomedical Science, Faculty of Dentistry, Khon Kaen University, 40002 Khon Kaen, Thailand.
Department of Medicine, Faculty of Medicine, Khon Kaen University, 40002 Khon Kaen, Thailand.
J Oral Facial Pain Headache. 2025 Mar;39(1):119-127. doi: 10.22514/jofph.2025.011. Epub 2025 Mar 12.
Trigeminal neuralgia (TN) is a severe neuropathic pain condition in the orofacial region, with carbamazepine recommended as the first-line treatment. Nonetheless, its application is constrained by unfavorable drug responses and side effects. The objective of this research was to assess the effectiveness and safety of lacosamide, a third-generation anticonvulsant, in individuals with TN, and to juxtapose the findings with observational records from recently diagnosed TN patients who underwent carbamazepine monotherapy within the corresponding timeframe.
An 8-week flexible dose titration of lacosamide was performed on newly diagnosed 12 TN patients who were divided into two groups: 200 mg/day (n = 5), and 400 mg/day (n = 7). Outcome measures included average pain score, Brief Pain Inventory-facial scores, and side effects. Patients were followed-up at 2, 4 and 8 weeks after baseline.
The percentage change of pain score at 4-week visit was compared between both lacosamide groups and patients receiving carbamazepine (n = 6) for four weeks during concurrent period. Both lacosamide groups experienced a decrease in pain score at 2-week follow-up, and differences in average pain score reduction were not observed between the two groups across all visits ( > 0.05). The mean Brief Pain Inventory-facial score in the lacosamide 200 mg/day group was higher than that in the 400 mg/day group at the 2-week follow-up ( = 0.03). Interestingly, the 4-week follow-up revealed that there were no significant variances in pain intensity between the lacosamide and the contemporaneous carbamazepine cohorts ( > 0.05). Frequently noted adverse events were mild somnolence (n = 9), slight vertigo (n = 5), and emotional lability (n = 2) without instances of severe adverse drug responses.
Lacosamide demonstrates potential as a therapeutic option for patients suffering from trigeminal neuralgia.
TCTR20210811002.
三叉神经痛（TN）是一种严重的口面部神经性疼痛疾病，卡马西平被推荐作为一线治疗药物。尽管如此，其应用受到不良药物反应和副作用的限制。本研究的目的是评估第三代抗惊厥药物拉科酰胺对TN患者的有效性和安全性，并将研究结果与同期接受卡马西平单药治疗的新诊断TN患者的观察记录进行对比。
对12例新诊断的TN患者进行为期8周的拉科酰胺灵活剂量滴定，患者分为两组：200毫克/天（n = 5）和400毫克/天（n = 7）。观察指标包括平均疼痛评分、简明疼痛量表面部评分和副作用。在基线后的第2、4和8周对患者进行随访。
比较了拉科酰胺两组与同期接受卡马西平治疗4周的患者（n = 6）在第4周就诊时疼痛评分的百分比变化。拉科酰胺两组在2周随访时疼痛评分均有所下降，在所有就诊期间两组平均疼痛评分降低幅度无差异（> 0.05）。在2周随访时，拉科酰胺200毫克/天组的简明疼痛量表面部平均评分高于400毫克/天组（= 0.03）。有趣的是，4周随访显示，拉科酰胺组和同期卡马西平组之间的疼痛强度无显著差异（> 0.05）。常见的不良事件为轻度嗜睡（n = 9）、轻微眩晕（n = 5）和情绪不稳定（n = 2），无严重药物不良反应发生。
拉科酰胺对三叉神经痛患者显示出作为一种治疗选择的潜力。
TCTR20210811002。
