Analysis: Gabapentin vs. Carbamazepine for Trigeminal Neuralgia
The superiority of gabapentin over carbamazepine in treating the chronic nerve condition trigeminal neuralgia remains inconclusive, according to the findings in a new meta-analysis published in the journal Pain Practice.
Researchers in China assessed 16 randomized controlled trials which included 1,331 patients to evaluate the safety and efficacy of gabapentin compared with carbamazepine for the treatment of trigeminal neuralgia.
Although the effective rate for the gabapentin group was superior to the carbamazepine group over a 4-week period (OR=1.495, 95% CI: 1.061, 2.107, P=0.022, heterogeneity: x2=7.12, P=0.625, I2=0.0%), the total effective rate of the gabapentin group was similar to the carbamazepine group (OR=1.600, 95% CI: 1.185, 2.161, P=0.002).
Life satisfaction rates were higher for the gabapentin therapy group after a 4-week period (SMD=0.966, 95% CI: 0.583, 1.348, P<0.001). Researchers also found that the rate of adverse reactions in the gabapentin therapy group was significantly lower than that of the carbamazepine therapy group (OR=0.312, 95% CI: 0.240, 0.407; P<0.001).
While treatment with gabapentin did show superiority in shorter time periods, the researchers concluded that the majority of trials analyzed were of a poor methodological quality. Therefore, more research is needed in order to conclude whether gabapentin is more effective or safer than carbamazepine.
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