Psychiatric Outcomes in Patients with Trigeminal Neuralgia Treated with Anticonvulsants and Antidepressants: A Retrospective Cohort Study Using a National Database
Background: Trigeminal Neuralgia (TN) is a chronic craniofacial condition characterized by intense, sporadic shocks of pain through the trigeminal nerve. The unpredictable and severe nature of these episodes can be physically and mentally debilitating, significantly affecting the quality of life an...
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| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
University Library System, University of Pittsburgh
2025-03-01
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| Series: | International Journal of Medical Students |
| Subjects: | |
| Online Access: | http://ijms.info/IJMS/article/view/2726 |
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| Summary: | Background: Trigeminal Neuralgia (TN) is a chronic craniofacial condition characterized by intense, sporadic shocks of pain through the trigeminal nerve. The unpredictable and severe nature of these episodes can be physically and mentally debilitating, significantly affecting the quality of life and often leading to anxiety, depression, and sleep disorders. This study investigated the psychiatric outcomes of anxiety, depression, and sleep disorders in TN patients who were treated with both anticonvulsants and antidepressants, compared to those who were treated only with anticonvulsants, to explore a multi-modal approach for addressing both pain and psychiatric symptoms.
Methods: A retrospective analysis of electronic health records was conducted using TriNetX, a collaborative health network encompassing over 250 million patient records worldwide. The analysis included 15,129 patient records, comparing two cohorts of TN patients.
Results: After adjusting for demographic factors, both cohorts were predominately female (73%), white (70%), and about 59 years of age. The results indicated that patients taking both anticonvulsants and antidepressants had higher risk, odds, and hazard ratios for developing depression (RR 10.448, OR 10.906, HR 10.763), anxiety (RR 2.680, OR 3.210, HR 3.013), and sleep disorders (RR 3.595, OR 3.696, HR 3.697) compared to those taking only anticonvulsants.
Conclusion: Despite limitations including inability to assess dosage and severity of pain, these findings suggest that concurrent use of anticonvulsants and antidepressants may exacerbate psychiatric symptoms in TN patients. However, these effects might improve with appropriate dosage adjustments, highlighting the need for including dosage adjustments and monitoring.
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| ISSN: | 2076-6327 |