Role of carbamazepine and oxcarbazepine for the treatment of chronic pain
Carbamazepine has established efficacy for the treatment of trigeminal neuralgia, as well as for painful traumatic neuropathy. Its side effect profile and potential for bone marrow suppression and hepatic side effects have resulted in it typically being used second line for neuropathic pain. General side effects include sedation, dizziness, unsteadiness, and rash, and blood monitoring is required to check for evidence of bone marrow suppression as well as hepatic effects.
Oxcarbazepine has been offered to patients who may have become refractory to treatment for carbamazepine for trigeminal neuralgia. Although not specifically FDA approved for trigeminal neuralgia, clinical experience and several studies have suggested that for certain patients, oxcarbazepine may be more effective and better tolerated than carbamazepine.
