Abstract
Background
Antiepileptic drugs are the first line treatment for trigeminal neuralgia (TN). Carbamazepine and oxcarbazepine are the most studied with well-known efficacy. Eslicarbazepine acetate is a third-generation antiepileptic drug that has not previously been evaluated for the treatment of TN. We aim to assess the efficacy, tolerability, and safety of eslicarbazepine for TN.
Design and Methods
Retrospective, open-label, multicentric, intention-to-treat study. We included patients older than 18 years who met the ICHD-3 beta diagnostic criteria for TN. We evaluated the variation of intensity and frequency of pain paroxysms before and after treatment with eslicarbazepine. Secondary objectives assessed were tolerability and safety of eslicarbazepine.
Results
Eighteen patients were included, 15 women, mean age 65.2 years-old, mean follow-up 21.1 months. The mean number of drugs tested before eslicarbazepine was 2; ten patients used eslicarbazepine as monotherapy. After the treatment with ESL, the median of pain intensity improved from 9.5 to 2.5 (p < 0.001) and the median of pain paroxysms frequency improved from 70 episodes per week to 0.37 (p < 0.001). Responder rate was 88.9%; 44.4% became asymptomatic after treatment. 61% of patients presented some adverse event; 4 patients discontinued eslicarbazepine for this reason. Despite this, 16 patients (88.9%) noticed a good subjective tolerance to eslicarbazepine. The retention rate at 6 months was 77.8% and at 12 months 61.1%.
Conclusions
Our study supports the hypothesis that eslicarbazepine acetate is an effective, safe, and well-tolerated treatment for the treatment of TN. Further studies are warranted to corroborate these results.
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