How to Treat Postherpetic Neuralgia: What Works?
How to Treat Postherpetic Neuralgia: What Works?
Why It Matters
PHN can be difficult to treat, but several therapies offer hope for relief. Let's dive into the most effective treatments available.
Contents
- First-Line Treatments
- Second-Line Options
- Topical and Adjunctive Therapies
First-Line Treatments
The first line of treatment for PHN includes gabapentinoids like gabapentin and pregabalin. These medications help reduce pain by altering nerve activity and are generally well-tolerated. Tricyclic antidepressants are another option, particularly for patients who can't take gabapentinoids.
Second-Line Options
For those who don't respond to first-line treatments, alternatives like serotonin-norepinephrine reuptake inhibitors (SNRIs) can be considered. These drugs are often used for neuropathic pain and depression, providing dual benefits for some patients.
Topical and Adjunctive Therapies
Topical treatments such as capsaicin cream or lidocaine patches may be effective for localized pain. In cases of severe or persistent pain, adjunctive options like opioids or intrathecal glucocorticoid injections may be necessary, but these are usually reserved for short-term use.
FAQs
What are first-line treatments?
Gabapentinoids and tricyclic antidepressants.
Are there second-line options?
Yes, SNRIs like duloxetine and venlafaxine.
What about topical treatments?
Capsaicin cream and lidocaine patches can help.
Are opioids used?
Only for severe or persistent pain as a last resort.
The Bottom Line
Effective treatment of PHN often requires a tailored approach, combining different therapies for optimal relief.
Additional References
- Watson CP, Evans RJ, Reed K, et al. Neurology 1982; 32:671.
- Boureau F, Legallicier P, Kabir-Ahmadi M. Pain 2003; 104:323.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic.