The first line of treatment for TN is usually medication, which often helps. But if medication doesn't relieve your pain or you have unbearable side effects such as extreme tiredness, your doctor may discuss surgical treatment with you. Typical analgesics (painkillers) and opioids (narcotic painkillers) do not usually relieve the sharp, recurring episodic pain caused by TN. There are many medication options that do work for facial pain. They include:
- No treatment – Your symptoms might go away without using medication.
- Anticonvulsant medications – These medications keep your trigeminal nerve from sending too many signals ("firing" or "going off.") Some anticonvulsant medications are:
- Tegretol (carbamazepine)
- Neurontin (gabapentin)
- Trileptal (oxcarbazepine)
- Dilantin (phenytoin)
- Depakote (sodium valporate)
- Antispastic agents – for example, Lioresal (baclofen). These can be used if you have unpleasant side effects with anticonvulsant medication. They are not as effective as oral anticonvulsants.
- Benzodiazepines – for example, Klonopin (clonazepam). These can be used if you have unpleasant side effects with anticonvulsant medication. They are not as effective as oral anticonvulsants.
- Antidepressant drugs – for example, amitriptyline or tricyclic antidepressants. Some antidepressant medication also can relieve pain. They are not as effective as oral anticonvulsants.
- Opioids – narcotic medications. These are for short-term use only, especially in critical cases. Trigeminal neuralgia is usually resistant to opioids. They are not as effective as oral anticonvulsants.
Complementary medical treatments - Some patients report reduced pain or pain relief with complementary medicine (healthcare that is not standard care but can be used at the same time). Complementary treatments include:
- Chiropractic adjustment
- Self-hypnosis or meditation
- Nutrition therapy
- Electrical nerve stimulation
You are not likely to achieve long-lasting results or the best solution for your problem by only using complementary treatments.