<s>[INST] My sister is dealing with trigeminal neuralgia. So much pain even when she swallows. Can not eat or even brush her teeth without pain.  Neurontin cause her blood pressure to go up. She has been dealing with this for several months. She has been to her dentist, had chiropractic adjustments (which did help some). Also been to a neurologist one day, he will be out of the offfice for 3 weeks. Her next appt in 2 months. She does has an appt with another neurologist next week. But she is having a lot of pain today and for the last several days. Has lost 7 lbs (she cannot afford to lose). Any suggestions? [/INST] Hi, Thank you for posting your query. I can understand the extent of discomfort in your sister, on account of facial pain due to trigeminal neuralgia. Neurontin has been tried but is causing side effects. The best medication to be used in trigeminal neuralgia is regret (carbamazepine). I use it in initial doses of 200 mg twice daily, and depending on the response, the dose can be gradually increased to 600 mg twice daily. It is a generally safe medication, however, it may cause Chat Doctor.  Some patients may not respond to regret. They should undergo MRI and MR angiogram to find out the underlying reason for trigeminal neuralgia. Such refractory cases may require a surgery called as microvascular decompression (MVD). I hope it helps. Please get back if you require any additional information. Best wishes, </s>