Pimozide Therapy for Trigeminal Neuralgia-Reply

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