Medical Treatment

Medications to Treat Facial Pain

Many people with facial pain will utilize medication as their primary treatment unless or until it no longer works.  You may benefit from a combination of medications to get good pain coverage; sometimes you will also need  to start at a lower dosage and build up to your recommended dosage.  This is called “titration” and its purpose is to get your body adjusted slowly to the medications in order to reduce any possible negative side effects that may occur.

Good to Know:

You may benefit from two or more classes of medications, including an anti-seizure medication, a broad-based pain medication, an anti-anxiety medication, and/or a sleep medication. 
Be sure to read the label of all your medications, and watch carefully for side effects.  Notify your physician ASAP should any occur.  You will be wise to save the information that comes with your medications for future reference. (Suggestion:  store in a 3-ring binder with other papers and forms related to your illness.)
Maintain check-ins with your physician for monitoring your medication.  The medications taken for facial pain can have serious side effects for some people and must be closely monitored.
Fill all your prescriptions at just one or two pharmacies to give you an additional safety measure for ensuring that you are not  taking medications which may cause negative responses when taken together.  This also enables you to get printouts of all your medications at year end (or whenever you’d like one) to get a full summary of your medications and expenses.
Stay on top of your refill dates, so that you never go without adequate pain coverage.
Be careful about titration, either increasing or decreasing.  Titration means building or lessening of medications, step-by-step.  It is important to have a plan for increasing or decreasing your medication and to follow it carefully, so that you do not have negative side-effects.

Common Medications for the Treatment of Facial Pain

Anti-Seizure Medications (Also known as “anti-convulsants”)
People with neuropathic facial pain do not have seizures, per se, however, some conjecture that tiny scars occur on facial nerves which may be similar to the scarring that occurs on nerves from seizures, which may account for the effectiveness of such drugs.  Examples include Tegretal, Trileptal, Neurontin, Topomax, Lyrica, Dilantin, Zonegran)
Muscle Relaxers and Anti-Inflammatories
These are not likely to reduce the pain caused by your neuropathic pain, however, you may have muscular pain as a consequence or side effect of your facial pain, and this group of medications may reduce these negative effects.  Examples include Baclofen, Flexeril, Zanaflex, Ibuprofen, Acetominophin, Aspirin
Topical Analgesics
Some of these cream or patch analgesics (which means “pain fighter) medications may be purchased over-the-counter (OTC); others  will require a prescription.   They tend to reduce the pain on contact; patients may find them particularly helpful for minor flare-ups, or to help with the pain of Anesthesia Dolorosa.   Examples include Lidoderm, Capsacian, Lidocain, Zostrix
Anti-anxiety or Anti-Depressants

Although you may not “feel” anxious or depressed, research has shown that the use of these medications may reduce pain, plus help patients better manage the depression symptoms which may be present.  Examples include Cymbalta, Effexor, Prozac, Celexa, Zoloft

 

Judi Notes…
I resisted being treated for depression when my physician first mentioned to me that my symptoms seemed to suggest it.  I argued that I wasn’t depressed;  it was my pain that was causing depression-like symptoms.  A few months later, I woke up to a feeling of exhaustion and heaviness that wouldn’t leave me for days.  This time, I listened to my doctor, and am glad I did.   I’m no longer “hung up” on the word “depression”, and treating it as an important part of my quest to live as well as I can.

Sleep Medication
Sleeping cycles may often be impacted by pain, resulting in sleep deprivation.  A vicious cycle may begin, whereas, the more pain you experience, the less sleep you can get…the less sleep you get, the more pain you experience.  You may benefit from a sleeping aid  if you are experiencing sleep deprivation  symptoms such as:  anxiety, memory loss, falling asleep in the day, extreme fatigue, or rapidly changing emotions.    Examples include Lunesta, Trazodone, Ambien.
Opiate Pain Inhibitors
Although the use of opiates (medication derived from the opium plant) causes controversy, this is changing, as physicians become better able to prescribe proper dosages and specific kinds of medications to meet the unique needs of facial pain patients.  Examples include Oxycodone, Hydrocodone, MS Contin, Roxanol, Vicodin, Duragesic Patch, Methadone.
Medication Summary
Medication may be an effective treatment for facial pain, either by itself or in combination with other treatments.  If you are able to manage your pain well on medication without significant side effects, medication may be all you need to treat your facial syndrome.  Many have done so effectively for years.

To learn more about medications, be sure to review the books I suggest in “Closing Notes.”  Also, check out information provided in TNA’s site www.endthepain.org.  Finally, “google” is always a good resource.  For example, you might want to check out this article I found about the long-term treatment of trigeminal neuralgia with carbamazepine, published by J. C. Taylor, S. Brauer, and M. L. Espir: Click here to see the article