September 1989

Pimozide Therapy for Trigeminal Neuralgia

Author Affiliations

From the Sections of Psychopharmacology (Drs F. Lechin, van der Dijs, M. Lechin, and A. Lechin, and Mr Jiménez), Psychosomatic Medicine (Drs F. Lechin, van der Dijs, M. Lechin, A. Lechin, Gómez, Acosta, and Arocha), Neurology-Neurophysiology (Dr Amat and Mr Jiménez), and Clinical Neurochemistry (Drs F. Lechin and van der Dijs and Mr Jiménez), the Institute of Experimental Medicine, Central University of Venezuela School of Medicine, Caracas; the Department of Internal Medicine, Centro Clinico Profesional Caracas (Venezuela) (Drs F. Lechin, van der Dijs, M. Lechin, A. Lechin, and Villa); and the Hans Selye Institute of Psychosomatic Medicine, Caracas, Venezuela (Drs F. Lechin, van der Dijs, Gómez, Acosta, and Arocha and Ms Cabrera).

Arch Neurol. 1989;46(9):960-963. doi:10.1001/archneur.1989.00520450030015

• Pimozide was compared with carbamazepine in a double-blind crossover trial in 48 patients with trigeminal neuralgia who were refractory to medical therapy. Pimozide treatment produced greater reduction in trigeminal neuralgia symptoms than carbamazepine treatment. All of the pimozide-treated patients improved, while only 56% of carbamazepine-treated patients were relieved of their pain. Although both drugs provoked some adverse effects, it was not necessary to interrupt the trial in any case. After this 24-week trial, all patients began receiving pimozide and were followed up according to an open-label study design. In all cases, the pimozide dosage was progressively reduced until the minimal effective dose was reached. Central and peripheral mechanisms that may underlie pimozide-induced improvement are discussed.