Comparative evaluation of the efficacy of gabapentin and gabapentin in combination with nortriptyline in the management of pain-related temporomandibular disorders

Abstract

Background: Temporomandibular disorders (TMDs) are considered the most common orofacial pain conditions of nonodontogenic origin. The current perspective regarding TMD is multidimensional. If the pain becomes chronic, it can have a great impact on the social and emotional behavior of the patient. Materials and Methods: A total of 40 patients between the age groups of 18 and 45 years were included in the study. These patients were divided into two groups comprising 20 patients each. Group I was prescribed gabapentin and was advised to take the medicine twice daily. Group II was prescribed gabapentin along with nortryptyline twice daily. Patients in each group were evaluated at the end of every week using a visual analog scale (VAS) score for pain, maximum interincisal mouth opening, and several muscle tenderness sites for 3 weeks, and a comparison was made. Results: The age range in group I was 19-45 years, whereas in group II it was 18-45 years with a P value of 0.711. Female predominance was observed in both groups as 65% of patients were females in group I and 60% were females in group II and P value obtained was 0.74. VAS score decreased more rapidly in group II than group I. The P value obtained was <0.001 at the end of the third week. Comfortable moth opening shows a more effective increase in group II than group I. The P value (0.003) shows significance at the end of the third week. The mean number of muscle tenderness sites at the end of 3 weeks in group I and group II reduced to 1.15 and 0.40, respectively. Conclusion: The combination therapy of gabapentin with nortryptyline was found to be more effective than gabapentin alone.