 Temporomandibular disorder is one of the main reasons for the pain and damage to the function in the head, jaws and neck 1,2 term is somewhat misleading because it includes two types of pain, one originates from the temporomandibular joint , and another originates mainly from the muscles of mastication - Myofacial pain MFP. The last is the one we seek to explore the etiology of this pain is explained using a biological-psychological model, which reflects the complex interaction between physical factors, behavioral, social and emotional influences 3. The pain may last from weeks to many months; it is usually more severe on one side of the face, especially at pre-auricular area front ear. Intensity of the pain is usually moderate; it has a squeezing, dull nature. It worsens during mouth opening and often causes opening restriction 5, 4. One can find trigger points where the pain is harsh and radiates to remote areas. Treatment is often integrated, multi-systemic and comprehensive 7, 6: physical therapy, behavioral therapy, night splints, Trigger point injection, and the use of drugs from different families are used to manage and treat MVP. Among the drugs that we use routinely are: Amitriptyline and nortriptyline from the family of tricyclic antidepressants TACs. These drugs were originally intended to treat depression and now days there primary use is to treat chronic pain from muscle origin, the use is in low doses of 10-35 mg d, with no connection to the anti-depressive effect 8,9,10,11. . Gabapentin is gaba-amino buyic acid GABA analogue originally developed as an anti-epileptic 12. This drug is also used as a first treatment in neuropathic pain 13. A study published in 2007 by Kimos et al 14 suggested that using gabapentin at higher doses up to 4200 mg per day is a therapeutic option for myofacial pain. The authors prospectively examined the use of gabapentin versus placebo in myofacial pain over 12 weeks in 50 patients, of whom 36 completed the study, the results demonstrated improvement in any parameter. Another study conducted in our department and accepted for publication in journal of orafacail pain headache examined retrospectively gabapentin Vs amitriptyline with better results for gabapentin in more complex and widely spread disorder. To gabapentin side effect drug interactions profile better than amitriptyline 16. Moreover, gabapentin has no anticholinergic which usually limits the use of amitriptyline. Therefore, gabapentin may be an attractive alternative for the treatment of MFP. Our clinic use gabapentin routinely as second option after lack of response to amitriptyline. The aim of this study is to compare prospectively the efficacy amitriptyline in low doses up to 20 mg to gabapentin at low doses up to 900mg. 