J Korean Pain Soc.
2004 Dec;17(Suppl):S22-S28. 10.3344/kjp.2004.17.S.S22.
Pharmacologic Treatment of Postherpetic Neuralgia
- Affiliations
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- 1Department of Anesthesiology and Pain medicine, College of Medicine, The Catholic University of Korea, Korea. demoon@catholic.ac.kr
- KMID: 2199650
- DOI: http://doi.org/10.3344/kjp.2004.17.S.S22
Abstract
- Postherpetic neuralgia (PHN) is a common complication of herpes zoster, particularly in the elderly and people with severe symptoms and presentation. This reviews summarizes the published results of randomized trials involving the treatment for PHN conditions. Anticonvulsants, such as gabapentin, carbamazepine and lamotrigine, and tricyclic antidepressants, including amitriptyline and nortriptyline, have demonstrated efficacy in several studies in relieving the pain associated with PHN. However, the lack of head-to-head comparison studies of these agents has limited the conclusions that can be reached. Using quality-of-life study outcomes, treatment strategies must encompass the impact of therapeutic agents on the comorbid conditions of sleep disturbance, mood and the anxiety disorders associated with PHN. Despite these treatment advances, many patients remain refractory to current therapy, and the prevention of PHN has therefore become an important focus of current research. Looking to the future, emerging therapies, such as pregabalin and newer N-methyl-D-aspartate receptor blockers, may provide physicians and patients with new treatment options for the more effective relief of herpetic pain.
