Twenty-five patients affected by 30 episodes of tic douloureux were treated with a new anticonvulsant, clonazepam. In 40% there was complete control of the neuralgia and an additional 23.3% were significantly helped by the drug. Sixteen patients had previously been resistant to carbamazepine, and eight of them were completely and one partially relieved by clonazepam. The side-effects, somnolence and unsteadiness of gait, were present to some extent in 80 and 88% of the cases respectively, being severe in about half of them. It is concluded that clonazepam can be considered as a second choice for the treatment of this condition, after proven failure with carbamazepine. Possible mechanisms of action are discussed.
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