A 45-year-old woman presents with severe, intermittent, electric shock-like pain in the distribution of the right mandibular division of the trigeminal nerve. She reports no sensory deficits on examination. Which first-line medication is most appropriate?
- A Amitriptyline
- B Carbamazepine ✓
- C Pregabalin
- D Gabapentin
Correct answer: B. Carbamazepine
Explanation
Carbamazepine is the first-line drug for classical trigeminal neuralgia, as per standard neurology and pain guidelines. It works by blocking voltage-gated sodium channels, reducing ectopic discharges. Amitriptyline and gabapentinoids are used for other neuropathic pain conditions but are not first-line for trigeminal neuralgia.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.