About Trigeminal Neuralgia Trigeminal neuralgia commonly is called “tic douloureux” When severe, it is the most excruciating pain known to man. This pain most frequently involves the lower lip and lower teeth or the upper lip and cheek, but it also may involve the nose and the area above the eye. Routine pain medications often are ineffective in controlling this pain. The most effective drug for controlling this pain is Tegretol however; it often caused side effects such as somnolence, mental slowness, or imbalance. More serious side effects, such as blood and liver problems, may also occur. Dilantin, Baclofen, and Neurontin are also used for trigeminal neuralgia but are generally less effective. Almost all patients with trigeminal neuralgia initially obtain excellent relief from Tegretol, so we routinely recommend it. However, most patients find that, over time, larger and larger doses of medication are required and that it eventually becomes ineffective or caused intolerable side effects.