Trigeminal Neuralgia/Tegretol

  I have been on Tegretol since April 1997.  I started to break out in red spots, the largest one being 1" x 3/4".  That one was removed because it was close to the scar line from where I had breast cancer.
  The biopsy was sent out for special staining.  A preliminary bx stated it may be lymphoma.  It took 3 wks to come back and the final report said it was a lymphocytoma cutis, which is benign.  In the mean time I am
  still breaking out in tiny red spots here and there on my body.  Do you think this is from the Tegretol? And more recently, I have started to take Neurontin along with the Tegretol because the TN has gone out of control.
  I am in quite a bit of pain.  Everything is setting it off, from the cold weather, chewing, or just talking.  I am at my wits end. Please share any info you may have on pseudolymphomas and Tegretol. And also would like to
  know how Neurontin works and side effects of it.  The first day I took it I felt drunk. Is that a side effect?  My brother was on it for RSD and was totally spaced out.  I appreciate your help.

[CCF Neuro MD MJD]

Although not clearly indicated in texts such as the Physician's Desk Reference that describes side effects, pseudolymphoma even cutaneous forms have been noted in the medical literature after Carbamazepine (Tegretol). Best characterized is the syndrome of a Hypersensity syndrome with fever, rash and enlarged generalized lymph nodes. But recently, areas of purely dermatologic lyphoid cell proliferation has been noted.  It is an important thing to ask your neurologist about, because stopping Tegretol can result in improvement.  
As for the Neurontin (Gabapentin), it can work in Trigeminal Neuralgia though often not as effectively as Tegretol.  It can be sedating, an effect which many get used too.  Before stopping the drug, I would ask your doctor about starting it slowly and increasing the dose gradually to avoid over-sedation.  Other drugs such as Liorosil (Baclofen) have also been used for Trigeminal Neuralgia, but each drug tried should be given a proper attempt at increasing it to a full efficacious dose.