Management of Trigeminal Neuralgia with Add-On Homeopathic Medicines: A Double-Blind, Randomised, Placebo-Controlled Pilot Study

Background: The trial evaluates whether homeopathy can offer clinical benefits as an add-on therapy in reducing pain in Trigeminal Neuralgia (TN) patients. Methods: Parallel-arm, double-blind, randomised, placebo-controlled pilot trial. Seven hundred and fifty patients were screened at the neurology department of a tertiary care hospital in India, for at least 3 attacks of severe, electric shock-like unilateral facial pain lasting < 2 minutes, occurring in one/more divisions of the trigeminal nerve. Using computer-based randomisation software, 60 diagnosed patients, aged ≥ 30 years, enrolled by blinded investigators, were assigned (1:1) as per simple randomisation to receive either conventional treatment + placebo identical to homeopathic medicines (conventional group), or conventional treatment + individualised homeopathy, administered orally (adjunct group), and followed up for 6 months. The primary objective was to observe the change in TN pain through the brief pain inventory (BPI)-Facial score in 3 months. The secondary objective was to assess the holistic improvement in the participants through total and individual domain scores of BPI-Facial, which included pain intensity, general (GADL), and face-specific activities of daily living (FADL) at 6 months. Results: Through per-protocol analysis, a significant reduction of 83.3 ± 40.2 to 20.6 ± 21.0 was found in the BPI-facial score within 3 months in the adjunct group, as opposed to 65.3 ± 31.6 to 62.9 ± 31.1 in the conventional group ( p = 0.001). At 6 months, GADL reduced from 30.1 ± 17.3 to 5.9 ± 10.7 and 22.3 ± 14.5 to 21.3 ± 13.2 ( p = 0.001); FADL reduced from 33.7 ± 17.7 to 8.3 ± 14.2 and 25.5 ± 15.2 to 21.5 ± 13.9 in the adjunct and conventional groups, respectively ( p = 0.006). Pain intensity reduced from 19.5 ± 8.9 to 5.3 ± 7.1 in the adjunct, and from 17.5 ± 8.7 to 16.8 ± 9.2 in the conventional group ( p = 0.001). In the adjunct group, conventional medication could be reduced in nine participants, without relapse. Conclusion: Homeopathy may be a viable integrated approach for sustainable healthcare in TN.