It is common for trigeminal neuralgia pain to require adjustments over time. Please be reassured that effective options are available. First, discuss with your doctor if safely increasing the doses of your current medications, carbamazepine and amitriptyline, is appropriate, as your current doses are relatively low. If a dose increase is not suitable, you can ask about switching to or adding alternative medications like oxcarbazepine, gabapentin, baclofen, or pregabalin. Your doctor can guide you through these options to find the best relief.