Research article

Safety and efficacy of carbamazepine in the treatment of trigeminal neuralgia: A metanalysis in biomedicine

  • Received: 24 October 2023 Revised: 04 January 2024 Accepted: 12 January 2024 Published: 07 March 2024
  • Trigeminal neuralgia is a debilitating condition characterized by severe facial pain. Carbamazepine has been widely used as a first-line treatment option for trigeminal neuralgia, but there is a need to evaluate its safety and efficacy based on existing evidence. This meta-analysis aims to systematically assess the available literature and provide a comprehensive evaluation of the safety and efficacy of carbamazepine in the treatment of trigeminal neuralgia. A thorough search of electronic databases yielded a total of 15 relevant studies that met the inclusion criteria. The pooled analysis of these studies revealed that carbamazepine demonstrated significant efficacy in reducing pain intensity and frequency in patients with trigeminal neuralgia. Moreover, the drug was generally well-tolerated, with the most common adverse events being mild and transient. Subgroup analyses based on different dosages and treatment durations further supported the overall findings. However, caution should be exercised in patients with certain comorbidities or specific populations, as some rare but severe adverse events were reported. In conclusion, this meta-analysis provides strong evidence supporting the safety and efficacy of carbamazepine as a valuable therapeutic option for the management of trigeminal neuralgia. These results can guide clinicians in making informed decisions regarding the use of carbamazepine and contribute to optimizing treatment strategies for patients with trigeminal neuralgia. Further research is warranted to explore long-term safety and efficacy outcomes, as well as to compare carbamazepine with alternative treatment modalities.

    Citation: M. Guo, W. Shen, M. Zhou, Y. Song, J. Liu, W. Xiong, Y. Gao. Safety and efficacy of carbamazepine in the treatment of trigeminal neuralgia: A metanalysis in biomedicine[J]. Mathematical Biosciences and Engineering, 2024, 21(4): 5335-5359. doi: 10.3934/mbe.2024235

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  • Trigeminal neuralgia is a debilitating condition characterized by severe facial pain. Carbamazepine has been widely used as a first-line treatment option for trigeminal neuralgia, but there is a need to evaluate its safety and efficacy based on existing evidence. This meta-analysis aims to systematically assess the available literature and provide a comprehensive evaluation of the safety and efficacy of carbamazepine in the treatment of trigeminal neuralgia. A thorough search of electronic databases yielded a total of 15 relevant studies that met the inclusion criteria. The pooled analysis of these studies revealed that carbamazepine demonstrated significant efficacy in reducing pain intensity and frequency in patients with trigeminal neuralgia. Moreover, the drug was generally well-tolerated, with the most common adverse events being mild and transient. Subgroup analyses based on different dosages and treatment durations further supported the overall findings. However, caution should be exercised in patients with certain comorbidities or specific populations, as some rare but severe adverse events were reported. In conclusion, this meta-analysis provides strong evidence supporting the safety and efficacy of carbamazepine as a valuable therapeutic option for the management of trigeminal neuralgia. These results can guide clinicians in making informed decisions regarding the use of carbamazepine and contribute to optimizing treatment strategies for patients with trigeminal neuralgia. Further research is warranted to explore long-term safety and efficacy outcomes, as well as to compare carbamazepine with alternative treatment modalities.



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    [1] M. Yuan, H. Y. Zhou, Z. L. Xiao, W. Wang, X. L. Li, S. J. Chen, et al., Efficacy and safety of gabapentin vs. carbamazepine in the treatment of trigeminal neuralgia: A meta‐analysis, Pain Pract., 16 (2016), 1083–1091. https://doi.org/10.3389/fneur.2023.1045640 doi: 10.3389/fneur.2023.1045640
    [2] X. Zhao, S. Ge, The efficacy and safety of gabapentin vs. carbamazepine in patients with primary trigeminal neuralgia: A systematic review and meta-analysis, Front. Neurol., 14 (2023), 1045640.
    [3] H. Hu, L. Chen, R. Ma, H. Gao, J. Fang, Acupuncture for primary trigeminal neuralgia: A systematic review and PRISMA-compliant meta-analysis, Complement Ther. Clin. Pract., 34 (2019), 254–267. https://doi.org/10.1016/j.ctcp.2018.12.013 doi: 10.1016/j.ctcp.2018.12.013
    [4] Q. P. Wang, M. Bai, Topiramate versus carbamazepine for the treatment of classical trigeminal neuralgia: A meta-analysis, CNS Drugs, 25 (2011), 847–857. https://doi.org/10.2165/11595590-000000000-00000 doi: 10.2165/11595590-000000000-00000
    [5] M. E. Morra, A. Elgebaly, A. Elmaraezy, A. M. Khalil, A. M. Altibi, T. L. H. Vu, et al., Therapeutic efficacy and safety of Botulinum Toxin A Therapy in Trigeminal Neuralgia: A systematic review and meta-analysis of randomized controlled trials, J. Headache Pain, 17 (2016), 1–9. https://doi.org/10.1186/s10194-016-0651-8 doi: 10.1186/s10194-016-0651-8
    [6] Z. Yin, F. Wang, M. Sun, L. Zhao, F. Liang, Acupuncture methods for primary trigeminal neuralgia: A systematic review and network meta-analysis of randomized controlled trials, Evid. Based Complement. Alternat. Med., 6 (2022). https://doi.org/10.1155/2022/3178154 doi: 10.1155/2022/3178154
    [7] Z. Qin, S. Xie, Z. Mao, Y. Liu, J. Wu, Z. Furukawa, et al., Comparative efficacy and acceptability of antiepileptic drugs for classical trigeminal neuralgia: A Bayesian network meta-analysis protocol, BMJ open, 8 (2018), e017392. https://doi.org/10.1136/bmjopen-2017-017392 doi: 10.1136/bmjopen-2017-017392
    [8] A. Khandan, H. Jazayeri, M. Fahmy, M. Razavi, Hydrogels: Types, structure, properties, and applications, Biomat. Tiss. Eng., 4 (2017), 143–169.
    [9] A. Muñoz-Vendrell, R. Tena-Cucala, S. Campoy, B. García-Parra, J. Prat, et al., Oral lacosamide for the treatment of refractory trigeminal neuralgia: A retrospective analysis of 86 cases, J. Headache Pain, 63 (2023), 559–564. https://doi.org/10.1111/head.14505 doi: 10.1111/head.14505
    [10] G. De Stefano, G. Di Pietro, A. Truini, G. Cruccu, G. Di Stefano, Considerations when using gabapentinoids to treat trigeminal neuralgia: A review, Neuropsychiatr. Dis. Treat., 8 (2023), 2007–2012. https://doi.org/10.2147/NDT.S407543 doi: 10.2147/NDT.S407543
    [11] N. B. Finnerup, Trigeminal neuralgia and the merit of small clinical trials, Lancet Neurol., 21 (2022), 951–953. https://doi.org/10.1016/S1474-4422(22)00389-1 doi: 10.1016/S1474-4422(22)00389-1
    [12] L. Ang, H. J. Kim, J. W. Heo, T. Y. Choi, H. W. Lee, J. I. Kim, et al., Acupuncture for the treatment of trigeminal neuralgia: A systematic review and meta-analysis, Complement. Ther. Clin. Pract., 5 (2023), 101763. https://doi.org/10.1016/j.ctcp.2023.101763 doi: 10.1016/j.ctcp.2023.101763
    [13] S. Khijmatgar, Z. Naik, A. Carmichael, S. M. Siddique, A. Bagewadi, A. Dey Chowdhury, et al., Observational studies on the efficacy of carbamazepine and ascorbyl palmitate in managing trigeminal neuralgia, Eur. Rev. Med. Pharmacol. Sci., 26 (2022), 94–105. https://dx.doi.org/10.26355/eurrev_202212_30799 doi: 10.26355/eurrev_202212_30799
    [14] A. M. A. Kayani, M. S. Silva, M. Jayasinghe, M. Singhal, S. Karnakoti, S. Jain, et al., Therapeutic efficacy of botulinum toxin in trigeminal neuralgia, Cureus, 14 (2022). https://doi.org/10.7759/cureus.26856 doi: 10.7759/cureus.26856
    [15] A. S. Abduhamid, S. A. Mohammed, A. G. Abdullah, N. M. Abdullah, A. Abdullah, A. M. Alqrni, et al., Radiofrequency thermoablation of the peripheral branches of trigeminal nerve versus the Gasserian ganglion for treating idiopathic trigeminal neuralgia: A systematic review and meta-analysis, J. Clin. Neurosci., 104 (2022), 42–47. https://doi.org/10.1016/j.jocn.2022.08.005 doi: 10.1016/j.jocn.2022.08.005
    [16] P. Parikh, H. M. Abdallah, A. Patel, R. K. Shariff, K. W. Nowicki, A. Mallela, et al., Bibliometric analysis of the top 100 cited articles on stereotactic radiosurgery for trigeminal neuralgia., Asian J. Neurosurg., 18 (2023), 101–107. https://doi.org/10.1055/s-0043-1761240 doi: 10.1055/s-0043-1761240
    [17] S. S. Kaya, Ş. Çelik, Y. AKÇABOY, Efficacy and safety of combined thermocoagulation radiofrequency and pulse radiofrequency in the treatment of V2/3 trigeminal neuralgia, J. Med. Palliat. Care, 4 (2023), 252–257. https://doi.org/10.47582/jompac.1303163 doi: 10.47582/jompac.1303163
    [18] F. Saldaña, H. Flores-Arguedas, J. A. Camacho-Gutiérrez, I. Barradas, Modeling the transmission dynamics and the impact of the control interventions for the COVID-19 epidemic outbreak, Math. Biosci. Eng., 17 (2020), 4165–4183. https://doi.org/10.3934/mbe.2020231 doi: 10.3934/mbe.2020231
    [19] M. C. Penn, W. Choi, K. Brasfield, K. Wu, R. G. Briggs, R. Dallapiazza, et al. A Review of Medical and Surgical Options for the Treatment of Facial Pain, Otolaryngol. Clin. N. Am., 55 (2022), 607–632. https://doi.org/10.1016/j.otc.2022.03.001 doi: 10.1016/j.otc.2022.03.001
    [20] A. K. Allam, H. Sharma, M. B. Larkin, A. Viswanathan, Trigeminal neuralgia: Diagnosis and treatment, Neurol. Clin., 41 (2023), 107–121. https://doi.org/10.1016/j.ncl.2022.09.001 doi: 10.1016/j.ncl.2022.09.001
    [21] M. Ghosh, S. Mondal, S. Chakraborty, N. Ghosh, A stability indicating method was developed and validation for the estimation of carbamazepine in bulk and tablet dosage form by UV-spectroscopic techniques, JDDT, 13 (2023), 85–104. https://doi.org/10.22270/jddt.v13i3.5987 doi: 10.22270/jddt.v13i3.5987
    [22] J. Gao, Q. Jiang, B. Zhou, D. Chen, Convolutional neural networks for computer-aided detection or diagnosis in medical image analysis: An overview, Math. Biosci. Eng., 16 (2019), 6536–6561. https://doi.org/10.3934/mbe.2019326 doi: 10.3934/mbe.2019326
    [23] R. F. V. Nascimento, L. Z. Pipek, P. H. P. de Aguiar, Is percutaneous balloon compression better than microvascular decompression to treat trigeminal neuralgia? A systematic review and meta-analysis, J. Clin. Neurosci., 109 (2023), 11–20. https://doi.org/10.1016/j.jocn.2023.01.002 doi: 10.1016/j.jocn.2023.01.002
    [24] Z. Sun, L. Liu, H. Liu, F. Luo, Effectiveness and safety of radiofrequency thermocoagulation treatment guided by computed tomography for infraorbital neuralgia following failed conservative treatment: A retrospective study, J. Pain Res., 4 (2023), 1005–1015. https://doi.org/10.2147/JPR.S395420 doi: 10.2147/JPR.S395420
    [25] A. Agarwal, S. Rastogi, N. Singh, M. K. Singh, Y. Litin, S. Bhasin, Percutaneous treatment of trigeminal neuralgia: A narrative review, Indian J. Pain, 36 (2022), 31–39. https://doi.org/10.4103/ijpn.ijpn_119_22 doi: 10.4103/ijpn.ijpn_119_22
    [26] H. Q. Ling, Z. H. Chen, L. He, F. Feng, C. G. Weng, S.J. Cheng, et al., Comparative efficacy and safety of 11 drugs as therapies for adults with neuropathic pain after spinal cord injury: A Bayesian network analysis based on 20 randomized controlled trials, Front. Neurol., 13 (2022), 818522. https://doi.org/10.3389/fneur.2022.818522 doi: 10.3389/fneur.2022.818522
    [27] T. Tangney, E. S. Heydari, B. L. Sheldon, A. Shetty, C. E. Argoff, O. Khazen, et al., Botulinum toxin as an effective treatment for trigeminal neuralgia in surgical practices, Stereotact. Funct. Neurosurg., 100 (2022), 314–320. https://doi.org/10.1159/000526053 doi: 10.1159/000526053
    [28] R. Xu, S. K. Nair, P. P. Shah, N. Kannapadi, J. Materi, S. Alomari, et al., A potential role for steroids in acute pain management in patients with trigeminal neuralgia, World Neurosurg., 167 (2022), e1291–e1298. https://doi.org/10.1016/j.wneu.2022.09.025 doi: 10.1016/j.wneu.2022.09.025
    [29] S. Li, G. Cheng, Y. Wu, C. Liao, W. Zhang, Long-term pain outcomes in trigeminal neuralgia patients with concomitant continuous pain: A comparison of first-time microvascular decompression and percutaneous balloon compression, Neurosurg. Rev., 46 (2023), 183. https://doi.org/10.1007/s10143-023-02089-y doi: 10.1007/s10143-023-02089-y
    [30] T. Sari, M. El Hajji, J. Harmand, The mathematical analysis of a syntrophic relationship between two microbial species in a chemostat, Math. Biosci. Eng., 9 (2012), 627–645. https://doi.org/10.3934/mbe.2012.9.627 doi: 10.3934/mbe.2012.9.627
    [31] J. J. Ierano, D. M. Richards, Atlas orthogonal chiropractic management of trigeminal neuralgia: A series of case reports, Explore, 4 (2023). https://doi.org/10.1016/j.explore.2023.06.004 doi: 10.1016/j.explore.2023.06.004
    [32] W. Yoshizaki, Y. Fujikawa, S. Torikoshi, T. Katayama, K. Iwasaki, H. Toda, Effects of microvascular decompression on quality-of-life in trigeminal neuralgia patients aged 70 years and older, Surg. Neurol. Int., 14 (2023). https://doi.org/10.25259/SNI_997_2022 doi: 10.25259/SNI_997_2022
    [33] B. Kumar, Ayurvedic management of Trigeminal neuralgia by Jalauka Avacharana-An Experience, J. Ayurveda Integr. Med., 8 (2023), 279–282. https://doi.org/10.21760/jaims.8.6.45 doi: 10.21760/jaims.8.6.45
    [34] A. S. S. Andersen, T. B. Heinskou, M. S. Asghar, B. Rossen, N. Noory, E. A. Smilkov, et al., Intravenous fosphenytoin as treatment for acute exacerbation of trigeminal neuralgia: A prospective systematic study of 15 patients, Cephalalgia, 42 (2022), 1138–1147. https://doi.org/10.1177/03331024221094536 doi: 10.1177/03331024221094536
    [35] K. Karatsu, R. Tamura, T. Miyauchi, J. Sogano, U. Hino, T. Iwama, et al., Clinical effectiveness of mirogabalin besylate for trigeminal neuropathy after skull base surgery: Illustrative Cases, Medicine, 10 (2023), 48. https://doi.org/10.3390/medicines10080048 doi: 10.3390/medicines10080048
    [36] H. Jiang, D. Zou, P. Wang, L. Zeng, J. Liu, C. Tang, et al., Case report: Fully endoscopic microvascular decompression for trigeminal neuralgia, Front. Neurol., 13 (2023), 1090478. https://doi.org/10.3389/fneur.2022.1090478 doi: 10.3389/fneur.2022.1090478
    [37] Q. Chen, D. I. Yi, J. N. J. Perez, M. Liu, S. D. Chang, M. Barad, et al., The molecular basis and pathophysiology of trigeminal neuralgia, Int. J. Mol. Sci., 23 (2022), 3604. https://doi.org/10.3390/ijms23073604 doi: 10.3390/ijms23073604
    [38] X. Cao, Z. Shen, X. Wang, J. Zhao, W. Liu, G. Jiang, A meta-analysis of randomized controlled trials comparing the efficacy and safety of pregabalin and gabapentin in the treatment of postherpetic neuralgia, Pain Ther., 12 (2023), 1–18. https://doi.org/10.1007/s40122-022-00451-4 doi: 10.1007/s40122-022-00451-4
    [39] A. S. S. Andersen, T. B. Heinskou, P. Rochat, J. B. Springborg, N. Noory, E. A. Smilkov, et al., Microvascular decompression in trigeminal neuralgia-a prospective study of 115 patients, J. Headache Pain, 23 (2022), 1–15. https://doi.org/10.1186/s10194-022-01520-x doi: 10.1186/s10194-022-01520-x
    [40] L. Bendtsen, J. M. Zakrzewska, T. B. Heinskou, M. Hodaie, P. R. L. Leal, T. Nurmikko, et al., Advances in diagnosis, classification, pathophysiology, and management of trigeminal neuralgia, Lancet Neurol., 19 (2020), 784–796. https://doi.org/10.1016/S1474-4422(20)30233-7 doi: 10.1016/S1474-4422(20)30233-7
    [41] G. Di Stefano, G. De Stefano, C. Leone, A. Di Lionardo, G. Di Pietro, A. Sgro, et al., Real‐world effectiveness and tolerability of carbamazepine and oxcarbazepine in 354 patients with trigeminal neuralgia, Eur. J. Pain, 25 (2021), 1064–1071. https://doi.org/10.1002/ejp.1727 doi: 10.1002/ejp.1727
    [42] L. Zhou, Y. Liu, H. Sun, H. Li, Z. Zhang, P. Hao, Usefulness of enzyme-free and enzyme-resistant detection of complement component 5 to evaluate acute myocardial infarction, Sens. Actuators B Chem., 369 (2022), 132315. https://doi.org/10.1016/j.snb.2022.132315 doi: 10.1016/j.snb.2022.132315
    [43] S. Hao, P. Jiali, Z. Xiaomin, W. Xiaoqin, L. Lina, Q. Xin, et al., Group identity modulates bidding behavior in repeated lottery contest: neural signatures from event-related potentials and electroencephalography oscillations, Front. Neurosci., 17 (2023). https://doi.org/10.3389/fnins.2023.1184601 doi: 10.3389/fnins.2023.1184601
    [44] Q. Guo, T. Li, Y. Qu, M. Liang, Y. Ha, Y. Zhang, et al., New research development on trans fatty acids in food: Biological effects, analytical methods, formation mechanism, and mitigating measures, Prog. Lipid Res., 89 (2023), 101199. https://doi.org/10.1016/j.plipres.2022.101199 doi: 10.1016/j.plipres.2022.101199
    [45] Y. Zhu, R. Huang, Z. Wu, S. Song, L. Cheng, R. Zhu, Deep learning-based predictive identification of neural stem cell differentiation, Nat. Commun., 12 (2021), 2614. https://doi.org/10.1038/s41467-021-22758-0 doi: 10.1038/s41467-021-22758-0
    [46] Z. Tian, Y. Zhang, Z. Zheng, M. Zhang, T. Zhang, J. Jin, et al., Gut microbiome dysbiosis contributes to abdominal aortic aneurysm by promoting neutrophil extracellular trap formation, Cell Host Microbe, 30 (2022), 1450–1463. https://doi.org/10.1016/j.chom.2022.09.004 doi: 10.1016/j.chom.2022.09.004
    [47] J. Li, Y. Chen, Q. Xiang, J. Xiang, Y. Tang, L. Tang, 5HTTLPR polymorphism and postpartum depression risk A meta-analysis, Medicine, 99 (2020), e22319. https://doi:10.1097/MD.0000000000022319 doi: 10.1097/MD.0000000000022319
    [48] Y. Chen, L. Chen, Q. Zhou, Genetic association between eNOS gene polymorphisms and risk of carotid atherosclerosis A meta-analysis, Herz, 46 (2021), 253–264. https://doi.org/10.1007/s00059-020-04995-z doi: 10.1007/s00059-020-04995-z
    [49] J. Li, J. Luo, L. Liu, H. Fu, L. Tang, The genetic association between apolipoprotein E gene polymorphism and Parkinson disease: A meta-Analysis of 47 studies, Medicine, 97 (2018), e12884. https://doi.org/10.1097/MD.0000000000012884 doi: 10.1097/MD.0000000000012884
    [50] Y. X. Song, X. Li, S. D. Nie, Z. X. Hu, D. Zhou, D. Y. Sun, et al., Extracellular vesicles released by glioma cells are decorated by Annexin A2 allowing for cellular uptake via heparan sulfate, Cancer Gene Ther., 30 (2023), 1156–1166. https://doi.org/10.1038/s41417-023-00627-w doi: 10.1038/s41417-023-00627-w
    [51] W. Tang, Y. Luo, X. Duan, Distribution of the Retinal Microcirculation Based on the Morphology of the Optic Nerve Head in High Myopia, Semin. Ophthalmol., 38 (2023), 584–591. https://doi.org/10.1080/08820538.2023.2169581 doi: 10.1080/08820538.2023.2169581
    [52] L. Tang, Q. Xiang, J. Xiang, J. Li, D. Chen, A variant in the 3ʹ-untranslated region of the MC2R gene decreases the risk of schizophrenia in a female Han Chinese population, Int. J. Med. Res., 49 (2021), 675876864. https://doi.org/10.1177/03000605211029504 doi: 10.1177/03000605211029504
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