COMPARISON OF QUALITY OF LIFE IN PATIENTS OF TRIGEMINAL NEURALGIA WHO ARE RECEIVING PREGABALIN AS AN ADD ON THERAPY TO CARBAMAZEPINE

Arvind Narwat*, Vivek Sharma and Kiran Bala

ABSTRACT

Objective: Patients with trigeminal neuralgia suffer pain episode for months or years before the condition is finally diagnosed and unfortunately episodes of trigeminal neuralgia have a devastating impact on patients Quality of life. This study was done with an aim to compare the quality of life in patients of trigeminal neuralgia who are receiving pregabalin as an add on therapy to carbamazepine. Materials and Methods: A prospective, open label, randomized, comparative clinical study conducted on 50 patients. The patients were randomly divided in two groups of 25 patients to receive following two treatments. Group I (n=25) received tablet carbamazepine as a monotherapy initially 200 mg daily per orally in divided doses and gradually built up as per clinical response with maximum titrated dose upto 1000mg/day. Group II (n=25) received capsule pregabalin 75 mg OD and tablet carbamazepine 200 mg daily per orally in divided doses and dose gradually built up as per clinical response with maximum titrated dose upto 300mg/day for pregabalin for a period of 12 weeks. Quality of life assessment was done by Pain disability index (PDI). The patients were assessed at the end of 4th, 8th and 12th weeks. Results: On intragroup analysis there was statistically significant reduction in mean PDI score (p<0.05 indicating improvement in quality of life) when compared to baseline values at the end of 4th, 8th and 12th weeks with both the drugs. In group I mean score at baseline was 48.08 ± 1.03, (43.52 ± 1.07) at 4th week, (40.24± 0.95) at 8th week and (37.44 ± 0.94) at 12th week. In group II mean score at baseline was 47.80 ± 0.53, (41.60 ± 0.51) at 4th week, (37.20± 0.52) at 8th week and (33.12 ± 0.60) at 12th week. On intergroup analysis it was observed that there was no statistically significant difference (improvement in quality of life) between the two treatment groups at the end of 4 weeks (43.52±1.07 vs 41.60±0.51; p=0.15), although statistically significant better quality of life was observed with pregabalin as an add therapy to carbamazepine at the end of week 8th (40.24 ±0.95 vs 37.20±0.52; p<0.05), and 12th (37.44±0.94 vs 33.12 ±0.60; p<0.05), indicating better quality of life with pregabalin. Conclusion: The present study suggested that pregabalin as an add on therapy to carbamazepine was found to cause significant improvement in quality of life & reduction in pain scoring at 8th & 12 weeks.

Keywords: Carbamazepine, pregabalin, trigeminal neuralgia, pain disability index.