{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T04:34:42Z","timestamp":1788582882176,"version":"build-2803163510"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,5,2]],"date-time":"2023-05-02T00:00:00Z","timestamp":1682985600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Drug therapy is the most commonly used treatment for primary trigeminal neuralgia (PTN), in which carbamazepine is the first-line drug. Recently, the anti-epileptic drug gabapentin has also been widely used in patients with PTN, but whether it can be used as a substitute for carbamazepine still needs to be verified. Our study aimed to assess the safety and efficacy of gabapentin vs. carbamazepine as a treatment for PTN.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched seven electronic databases for studies published as of 31 July 2022. All randomized controlled trials (RCTs) of gabapentin vs. carbamazepine on patients with PTN that met the inclusion criteria were included. Meta-analysis was conducted using Revman 5.4 and Stata 14.0, in which forest plots, funnel plots, and sensitivity analysis were performed. Mean difference (MD) and odds ratio (OR) with 95% confidence intervals (CIs) were used for the measurement indicators of continuous and categorical variables, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 18 RCTs with 1,604 patients were eventually identified. The meta-analysis showed that compared with the carbamazepine group, the gabapentin group significantly improved the effective rate (OR = 2.02, 95% CI 1.56 to 2.62, <jats:italic>P<\/jats:italic> &amp;lt; 0.001), reduced the adverse event rate (OR = 0.28, 95% CI 0.21 to 0.37, <jats:italic>P<\/jats:italic> &amp;lt; 0.001), and improved the visual analog scale (VAS) score (MD = \u22120.46, 95% CI \u22120.86 to \u22120.06, <jats:italic>P<\/jats:italic> = 0.03). Although the funnel plot showed evidence of publication bias, the sensitivity analysis revealed the stability of the results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The current evidence showed that gabapentin may be superior to carbamazepine in relation to efficacy and safety in patients with PTN. It is crucial that more RCTs are conducted to confirm the conclusion in the future.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2023.1045640","type":"journal-article","created":{"date-parts":[[2023,5,2]],"date-time":"2023-05-02T04:26:25Z","timestamp":1683001585000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":20,"title":["The efficacy and safety of gabapentin vs. carbamazepine in patients with primary trigeminal neuralgia: A systematic review and meta-analysis"],"prefix":"10.3389","volume":"14","author":[{"given":"Xin","family":"Zhao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuyu","family":"Ge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,5,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"289","DOI":"10.2147\/TCRM.S37592","article-title":"Advances in diagnosis and treatment of trigeminal neuralgia","volume":"11","author":"Nicola","year":"2015","journal-title":"Ther Clin Risk Manage."},{"key":"B2","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1212\/WNL.0000000000002840","article-title":"Trigeminal neuralgia: new classification and diagnostic grading for practice and research","volume":"87","author":"Cruccu","year":"2016","journal-title":"Neurology."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1322","DOI":"10.1111\/head.14414","article-title":"Treatment of multiple sclerosis\u2013related trigeminal neuralgia with onabotulinumtoxin A","volume":"62","author":"Asan","year":"2022","journal-title":"J Head Face Pain."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/0333102417738202","article-title":"Headache Classification Committee of the International Headache Society (IHS) the International Classification of Headache Disorders","volume":"38","year":"2018","journal-title":"Cephalalgia"},{"key":"B5","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/j.mehy.2017.01.008","article-title":"Primary trigeminal neuralgia and the role of pars oralis of the spinal trigeminal nucleus","volume":"100","author":"Peker","year":"2017","journal-title":"Med Hypotheses."},{"key":"B6","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1186\/s10194-019-0969-0","article-title":"Trigeminal neuralgia secondary to multiple sclerosis: from the clinical picture to the treatment options","volume":"20","author":"Di Stefano","year":"2019","journal-title":"J Headache Pain."},{"key":"B7","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1093\/brain\/awu349","article-title":"Significance of neurovascular contact in classical trigeminal neuralgia","volume":"138","author":"Stine","year":"2015","journal-title":"Brain."},{"key":"B8","doi-asserted-by":"publisher","first-page":"106397","DOI":"10.1016\/j.clineuro.2020.106397","article-title":"Molecular mechanisms of trigeminal neuralgia: a systematic review","volume":"2021","author":"Smith","year":"2021","journal-title":"Clin Neurol Neurosur."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1441","DOI":"10.1111\/head.14212","article-title":"Characteristics and natural disease history of persistent idiopathic facial pain, trigeminal neuralgia, and neuropathic facial pain","volume":"61","author":"Ziegeler","year":"2021","journal-title":"Headache."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1064","DOI":"10.1002\/ejp.1727","article-title":"Real-world effectiveness and tolerability of carbamazepine and oxcarbazepine in 354 patients with trigeminal neuralgia","volume":"25","author":"Di Stefano","year":"2021","journal-title":"Eur J Pain."},{"key":"B11","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1016\/j.wneu.2020.06.206","article-title":"Internal neurolysis with and without microvascular decompression for trigeminal neuralgia: case series","volume":"6","author":"Sabourin","year":"2020","journal-title":"World Neurosurg."},{"key":"B12","doi-asserted-by":"publisher","first-page":"399","DOI":"10.4103\/0028-3886.315996","article-title":"Medical management of trigeminal neuralgia","volume":"168","author":"Khadilkar","year":"2021","journal-title":"Neurol India."},{"key":"B13","doi-asserted-by":"publisher","first-page":"638","DOI":"10.1007\/s11596-019-2085-4","article-title":"Triple puncture for primary trigeminal neuralgia: a randomized clinical trial","volume":"39","author":"Zhang","year":"2019","journal-title":"Curr. 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