title: Use of single- and multi-drug regimens in the management of classic (idiopathic) trigeminal neuralgia: an 11-year experience at a single Sri Lankan institution.
abstract: OBJECTIVE
  The aim of this retrospective study was to evaluate the outcome of medical treatment of classic trigeminal neuralgia and to assess the factors affecting the choice of drug regimen (single or multiple), and the duration of treatment for pain control.
  
  
  METHODS
  A total of 260 consecutive patients were included in the study. Sixty-one patients with less than 6 months' follow up were excluded. All patients were treated with carbamazepine alone or in combination with other drugs. The dosage was adjusted according to the level of pain control and side-effects.
  
  
  RESULTS
  Treatment was terminated in 99 patients (49.7%) after a mean follow-up period of 36.46 months (standard deviation: ±26.5). Of these, 39.4% were on a single drug. Carbamazepine was the drug used in 36 patients. The rest (61%) needed various combinations of drugs. One-hundred patients (50.3%) continued with medical treatment during the follow-up period. Of these, 67.4% were on multi-drug therapy.
  
  
  CONCLUSIONS
  The present study showed that the administration of multidrug regimens is a useful alternative in controlling trigeminal neuralgia in patients who are unable to tolerate higher doses of carbamazepine. Age, sex, ethnicity, and the side of affliction did not have a significant influence on the choice of drug regimen and the duration of treatment for pain control.
authors.affiliation: Department of Oral Medicine and Periodontology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka. spaga@pdn.ac.lk
authors.forename: Anura
authors.initials: A
authors.lastname: Ariyawardana
authors.forename: Ranjith
authors.initials: R
authors.lastname: Pallegama
authors.forename: Mohaideen
authors.initials: M
authors.lastname: Sitheeque
authors.forename: Ajith
authors.initials: A
authors.lastname: Ranasinghe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000588:Amines / Q000627:therapeutic use*; D000639:Amitriptyline / Q000627:therapeutic use*; D000700:Analgesics / Q000627:therapeutic use*; D002220:Carbamazepine / Q000627:therapeutic use*; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D000077206:Gabapentin; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010672:Phenytoin / Q000627:therapeutic use*; D012189:Retrospective Studies; D013188:Sri Lanka; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000188:drug therapy*; D014635:Valproic Acid / Q000627:therapeutic use*; D005680:gamma-Aminobutyric Acid / Q000627:therapeutic use*
chemical_list: D000588:Amines; D000700:Analgesics; D003509:Cyclohexanecarboxylic Acids; D000639:Amitriptyline; D002220:Carbamazepine; D005680:gamma-Aminobutyric Acid; D014635:Valproic Acid; D010672:Phenytoin; D000077206:Gabapentin