Post Surgical Cranial Neuralgia Treatment: Carbamazepine VS Carabamazepine ER

I have a type of neuralgia caused by brain surgery which my neurologist has deemed "Cranial Neuralgia" but can be most closely compared to TN type 2.

My doctor just switched me from regular carbamazepine to carbamazepine ER because I've been having more breakthrough pains lately.

I've only been on the new meds for 3 days, but it seems like the pain is worse. Has anyone else made the switch from standard to ER? did you have a period of increased pain while adjusting?


I didn't respond well to Tegretol ER, but I've read about other people doing better on it. I hope your pain settles down. If not, ask your doctor to switch you back!

You might need a higher dose of the ER. It is extended release so it is spreading out the dose vs the regular Tegretol that just dumps the dose upfront. The dump probably does a good job of managing that pain but then when it tapers off in between, you are getting breakthrough. Hope this makes a little sense. I had to switch to the Teg ER form Trileptal because the "drug dumps" on the super high dose I was on was causing really, really bad side effects (hallucination like states). The ER managed those intense side effects by spreading out the dose and I of course was on the max dose with that at 1200mg before I had my MVD 10 months ago (pain free and med free now!!).