I have seen this mentioned in previous discussions but they were quite old and I think the more widely this is known the better.
If you've been diagnosed with ATN or some sort of Myofascial or Atypical Facial Pain, and haven't been down this route, it would be well worth considering.
This does NOT substitute the professional advice of a Doctor, GP or other medical professional and are only the result of my own personal experience.
If you are able to tolerate, and are getting some benefit from an AED like gabapentin/pregabalin/tegretol along with a TCA like Amitryptaline, you may also find a muscle relaxant helpful as sometimes this type of shooting/stabbing pain can be caused by nerves getting impinged on by tight muscles (I am not a scientist, and I'm on just over 2grams per day of "Morontin" so my advice can be taken with a pinch of salt).
If some of your pain is part of a Spasm/Pain cycle, then shorter acting drugs like Diazepam and Temazepam can help to loosen the muscles. Clonazepam is a longer acting drug that is meant to be taken long term. These drugs have an Anti-convulsant property, amongst others, and people with TMD may benefit especially as TN can have similar symptoms.
There is only one problem and that is that drugs from this family can be very habit forming i.e. addictive for those with personalities vulnerable to these behaviours. But if you can be disciplined to only take a little as possible (e.g. 2-4 mg of Diazepam) and as least often as possible, they successfully help some kinds of pain, and hopefully break the cycle!
Ideally one shouldn't have to take these drugs at all and the supplement Magnesium is also important for muscles but sometimes if you need a spasm in your ear canal, or temporalis, or hamstrings to subside, then perhaps it might be worth letting your doctor suggest one of these drugs to you.
Low pain days to you all,
Luke.