Does Intake Of Opioids Help In Treating Trigeminal Neuralgia?

Posted on Wed, 8 Jun 2016

Question: I have atypical trigeminal neuralgia and have been prescribed and take dilaudid , 4 mg every 4-6 hours as needed. I have recently met with a new pain management doctor who will only prescribe time released morphine type medications. I don't know what to expect. I have tried Norco before and it had absolutely no pain relief. what is so wrong with a treatment that works? this new doctor told me he would only prescribe my current medication if I was a stage 4 cancer patient.

Answered by Dr. Ajay Panwar (9 hours later)

Brief Answer:
Opioids are not the preferred medications in Trigeminal neuralgia.

Detailed Answer:
Hi XXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.

I understand your concern and I shall try to guide you suitably.

Dilaudid is an opioid medication. Opioids are not the drug of choice or preferred medicines for Trigeminal neuralgia.Even if you are responding to it, your doctor might be asking you not to overuse it because chronic opioid intake may land into abuse and addiction.

Other first line drugs like carbamazepine or other anticonvulsants may be used. Baclofen may be added as well.
Even if then,the pain does not respond,surgery(microvascular decompression,gamma knife radiosurgery) has a well proven evidence for Trigeminal neuralgia.

Bottom line-As far as Trigeminal neuralgia is concerned,opioid therapy is not evidence based.In addition,it may result in long term harm.

Hope that helps.If you have some further questions,I shall be glad to have you in follow-up.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar