Which treatment option is considered first-line for trigeminal neuralgia?

Carbamazepine is considered the first-line treatment for trigeminal neuralgia due to its ability to effectively reduce the incidence and severity of pain associated with the condition. Trigeminal neuralgia, characterized by abrupt, severe facial pain, often requires interventions that directly target nerve excitability and pain transmission pathways. Carbamazepine works by stabilizing neuronal membranes and inhibiting excitatory neurotransmission, which helps alleviate the intense episodes of pain that patients experience.

The efficacy of carbamazepine has been well established in clinical studies, making it the go-to option for neurologists when treating this specific type of neuropathic pain. While other medications, such as gabapentin, may also provide relief for neuropathic pain, they are usually not first-line options for trigeminal neuralgia specifically. Gabapentin may serve as a second-line option or for additional pain management in cases where carbamazepine is ineffective or causes side effects. In contrast, ibuprofen, being a nonsteroidal anti-inflammatory drug (NSAID), does not directly address the underlying nerve-related pain and is not indicated for the treatment of trigeminal neuralgia. Similarly, amitriptyline, although used for various types of chronic pain