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April 1990

Pimozide Therapy for Trigeminal Neuralgia-Reply

Author Affiliations

Apartado 80983 Caracas 1080-A, Venezuela

Arch Neurol. 1990;47(4):382. doi:10.1001/archneur.1990.00530040022012

In Reply.  —We agree with Ecker's comments as to standard labeling of trigeminal neuralgia or, what he calls "classic... tic douloureux."1 Nonetheless, we have treated atypical as well as classic patients (not included in our double-blind study), with results similar to those that appeared in our article, where we only included those patients who had no periods of spontaneous remission; no refractory periods were observed either. Normally, we use doses much lower than required for a double-blind study, thus reducing side effects considerably.In our opinion, pain location and projections correspond to involvement of distinct central topographical areas of the brain-stem sensory trigeminal nuclear complex2 related to the same neurochemical disorders: namely, a deficiency of central serotonergic activity.Following this trend, we have used different neuropharmacological manipulations, ie, a combination of drugs that interfere with central noradrenergic transmission (75 μg of clonidine plus 5 mg of levopromazine or

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