Do GABA uptake inhibitors herald a new generation of GABA-ergic drugs for trigeminal neuralgia?

Anticonvulsant drugs are the initial treatment of choice in trigeminal neuralgia. Historically, carbamazepine is and remains the gold standard. Many similarities between the pathophysiologic phenomena observed in epilepsy models and neuropathic pain models justify the rationale for the use of anticonvulsants in the management of neuropathic pain disorders. We have evidence that there is a high intensity of Gamma-aminobutyric acid transporters in the trigeminal sensory nuclei, and that Gamma-aminobutyric transporters expression was increased in the spinal trigeminal nucleus of rats after facial carrageenan injections. These are correlated with increased Gamma-aminobutyric acid uptake in the synaptosomal preparation from the spinal trigeminal nucleus of rats that received the injections and can be antagonised with glial uptake inhibitors. We conclude that Gamma-aminobutyric acid uptake inhibitors may prove to be a novel generation of GABAergic drugs for trigeminal neuralgia.