Brief Answer: Needs Management and tapering of dose Detailed Answer: Good Day XXXX! Thank you for asking. My name is Dr S Khan and i would like to help you with the issue of drowsiness you are facing for your facial neuralgia/ trigeminal neuralgia superseded by history of anxiety and depression you have. Mr berry i want to make it clear cut to you that you are on too much sedatives and they need to be tapered first if we need to manage the drowsiness, i mean diazepam, alprazolam and xanax are all the same class and single one of them would have been enough. So i request to have your doctor involved to reconsider the doses and taper them to the extent possible to avoid complications very small amongst them is drowsiness. And the age of 67 is a geriatric peak and at this age even simple dosages need to be halved for the reason of drug metabolism slowing down as the age progresses so one more reason to reconsider the dosages. Now lets talk about other ways to help the neuralgia managed. Talking about triggers would be a good start which are Chewing, talking, or smiling Drinking cold or hot fluids Touching, shaving, brushing teeth, blowing the nose Encountering cold air from an open automobile window SO above mentioned triggers need to be reduced to the extent of need and avoiding them where possible. Now other than triggers and medicines there are other ways like Percutaneous procedures (eg, percutaneous retrogasserian glycerol rhizotomy) Surgery (eg, microvascular decompression) Radiation therapy (ie, gamma knife surgery) so discuss these options with your healthcare provider and see if you can find a better solution in above mentioned choices. Now Mr berry i want you to know that these anticonvulsant drugs you have make these issues you are facing at the age you are, very likely and they need very strict monitoring and avoidance of driving and heavy machinery and being compliant and in constant touch with your provider. Plus you need to be absolutely aware of the disease and you need education for that. here is a link which will help you in that regard. NIH Neurological Institute PO Box 5801 Bethesda, MD 20824 Phone: (800) 352-9424 or (301) 496-5751 TTY (for people using adaptive equipment): (301) 468-5981 E-mail: WWW.WWWW.WW Web site: WWW.WWWW.WW TNA Facial Pain Association (formerly: Trigeminal Neuralgia Association) 408 W University Ave Suite 602 Gainesville, FL 32601 Phone: (800) 923-3608 or (352) 384-3600 E-mail: YYYY@YYYY Website: WWW.WWWW.WW Plus you should definitely have this questionnaire filled to see where do you stand regarding your symptoms. This questionnaire is designed for facial neuralgia patients. WWW.WWWW.WW Now the last question of yours of other possibilities of drugs for this trouble so there are a lot of anticonvulsants, skeletal muscle relaxants, Tricyclic antidepressants and toxins (botulinum) which you can select from after consulting with your Healthcare provider. Mr Berry have a very good rest of the day and may the odds be always in your favour. Kindly close the discussion if thats it from your side , if you have to ask more please do i would love to answer, other wise don't forget to close the discussion and rate the answer as per your experience. I will be here for you Regards Dr. S Khan

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