I started with oxcarbazepine only when I felt the discomfort half in morning and half at night. That worked for a few years, because the discomfort wasn't on a regular basis. After I had my first attack (electric shock,) that lasted for 15 minutes on and off pain in the time, which you knew the next bout of pain was coming and you couldn't do anything about, but hope it wouldn't last as long as the last one. As the years went by the attacked were coming and I used the meds to stop pain before it came. It got to a point that the med didn't work and added another called gabapentin which pick-up the slack that oxcarbazepine wasn't doing on its own. When that happen I seek out a surgeon and had the mvd done. I spoke to many people I know who had or still have TN, everybody is different and your going to have your doctor and you figure out whats going to work for you. I know I was not going to be living or existing on drugs to get thru the day. if I had another option, which I took.. I am grateful every day to live a full day without meds and pain. Be well Carmelo.