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To the Editor: A 45-year-old hypertensive man presented to the emergency department complaining of facial pain on the right side. His blood pressure was well controlled with lisinopril 20 mg OD. On examination, he was vitally stable with a blood pressure of 120/80 mm of Hg and a heart rate of 72 beats per minute. His dental and systemic examination was unremarkable. He was diagnosed as a case of trigeminal neuralgia and was started on carbamazepine 300 mg OD. After 3 days, he presented to the emergency department with nausea and headache. His blood pressure was found to be 210/100 mm of Hg. The neurological examination was unremarkable. A blood pressure record was maintained, and it was persistently high. He was started on dual hypertensive therapy and, along with lisinopril 20 mg, hydrochlorothiazide 25 mg OD was added; the dose of carbamazepine was reduced to 150 mg OD, but the …