Despite the exemplary efficacy of
voltage-gated sodium channel blockers as a first-line treatment of
trigeminal neuralgia, the pharmacological management of this excruciating
facial pain condition remains a major issue, as these first-line drugs produce intolerable side effects in a significant portion of patients. In addition, in patients with concomitant continuous
pain, the efficacy of these drugs may drop, thus suggesting the opportunity to test the efficacy of different
drug categories. The aim of this review is to provide current, evidence-based, knowledge about the use of
gabapentin and other α2δ
ligands in patients with
trigeminal neuralgia. We searched for relevant papers within PubMed, EMBASE, the Cochrane Database of Systematic Reviews and the Clinical Trials database (ClinicalTrials.gov), considering publications up to April 2023. Two authors independently selected studies for inclusion and data extraction. The efficacy of α2δ
ligands,
gabapentin and
pregabalin, has been assessed in seven controlled or open-label studies. Despite the low quality of evidence, the favorable tolerability profile and the possible action on concomitant continuous
pain make this
drug category of interest for future trials in
trigeminal neuralgia.