Gabapentin dosage for trigeminal neuralgia?

Thanks to everyone posting their experiences with TN.

I'm so blessed that mine comes on for a relatively short spell (sometimes only a day, and the longest so far for a month), and then disappears for weeks / months. I feel for everyone who needs to resort to taking these strong meds on an ongoing basis to obtain some relief. So sorry!

/LarryG

@speercntry
I also take carbamazepine although I take the Brand name time release version (carbareol) for seizures. You post made me wonder if the pain from my Neuropathy went away when I started taking it. I wish I remembered. I take 1,000 mg a day.
Like some other seizure medications carbamazepine can lower your vitamin D level. If your doctor doesn’t order a vitamin D level you should probably suggest it. You may have to supplement your vitamin D. Also grapefruit and juice may increase the amount of carbamamzepine potentially increasing side effects. My brother also takes this medication and he drinks grapefruit juice but it has no effect on him.
Good luck,
Jake

The carbamazepine (200mg) I’ve been taking relieved my TN but I don’t like the side effects. I’m wondering now that the TN is controlled if I should go back to gabapentin (600mg). I never seemed to have any side effects from that. Hope you’re doing well.

@speercntry
I'm surprised you're having side effects on 200mg? I take 1,000 with no side effects. Sure a difference in people's reactions to medication.
I wonder if 100 mg in the morning and 100 mg at night or the extended-release version would improve your symptoms. There have also been studies showing increased side effects with generic vs brand drugs. Time-release meds also are known to improve side effects.
If given some time your side effects may decrease in severity or possibly disappear altogether although this could take from weeks to months.
I would guess that switching back to gabapentin wouldn't be a good idea.
I would guess a better alternative would be to ask your doctor if Oxcarbazepine would be a good alternative since it's supposed to be as effective as carbamazepine with fewer side effects.
Best of luck to you,
Jake

Thank you for your help, I’ll be talking with my doctor about those alternates. I really just hope this TN goes away like it did six years ago. Hate taking drugs. Thanks again!

Sorry to hear about your pain. Makes my struggles feel small compared to yours. Hope they can figure something out. They can’t do a nerve block or something along those lines? Hope you find some answers. Lars.

I know the feeling of losing yourself and your normal life while your family has to endure without you . It’s hard to believe that this is your life . I think your situation is why Mayo exists . You have some of the best Drs working in a concentrated fashion on your problem and it may be a good idea to just start over with a new perspective .
I know one thing , you can’t stop trying and don’t let this get you too down . It helps to talk to someone . I know this feels insurmountable but you never know what is in store for you in the future . It’s easy to lose yourself .
My advice is to get to Mayo and get a different viewpoint from different doctors . Don’t give up on this - there is hope .

I had a root canal dentist said it had cracked roots. She did it anyway got severe nerve damage. Pain in the ear eye and bridge of nose shooting pain up the head. I get sick from all the pain pills doctors said surgery is to dangerous. Had the tooth pulled it helped a little bit started accpuncture that helped a little bit better than nothing. I had 13 treatments so far hopefully more will help. Maybe you could try accpuncture.

In trials the good news is that there is less than a half a percent chance in getting a rash with Lamotrigine.
it sounds like the rash you’re talking about is Steven Johnson syndrome which in fact can potentially be deadly So call or get to your doctor or go to the emergency room at the first sign of symptoms. you might consider asking your neurologist do you have genetic testing to see if you’re susceptible to Steven Johnson’s which is more common in people of Asian descent but no one is immune.
Best of luck,
Jake

I am so very sorry that you are experiencing this menace! I have experienced a great deal of pain in my life, but this one quite literally brought me to my knees!
TN first appeared as intense pain in upper and lower molar pain. The dentist diagnosed TMJ and created a bite guard for me. The first time I inserted it in my mouth is when the lightning bolts shot through my face! It was agony! The odd thing that happened was the pain disappeared at night and allowed me to sleep. I was able to diagnose my condition because I was taking 900 mg. of gabapentin every night. The dentist confirmed my suspicion and prescribed a titrated gabapentin dose to 3,600 mg daily as tolerated. It worked like a miracle!
My pain lingers in my eyebrow, then radiates to my molars, and grows incessant in my jaw bone. If I don't respond with the increased gabapentin dosage, the occipital skull area joins in with great alarm!
It continues to live in the background and occasionally becomes intolerable if I floss on my left side too vigorously, chew anything crunchy on that side, consume anything too hot or cold, or even expose my face to a cold breeze.
I wish you the greatest results from whichever remedy you pursue, as this is a beast not easily tamed with just any treatment. For me, gabapentin has saved me from this "suicide disease"!
Warmest wishes,
Julia