Medication for the Treatment of Post-Herpetic Neuralgia

Post-Herpetic Neuralgia

Post-herpetic neuralgia is a painful condition that persists after a shingles episode is over. The sharp and shooting pain associated with post-herpetic neuralgia occurs in the same area as that of the pain and rash of shingles and results from the damage to nerve fibres during the shingles infection.

Post-herpetic neuralgia is not generally considered life threatening, though the condition can lead to insomnia, weight loss, depression and even disability in some cases. Patients may also become hypersensitive to even a very light touch or pressure on the skin, such as when touched by hand, a piece of cloth or even a gentle breeze.

Anti-Neuropathic Medication

Tricyclic antidepressants are normally the first medication prescribed for relief to a patient of post-herpetic neuralgia. The most common medications prescribed include Amitriptyline, Nortriptyline, Desipramine and Maprotiline.

Anticonvulsants, usually prescribed to treat epilepsy, are sometimes used in conjunction with tricyclic antidepressants. Certain anticonvulsants also provide relief for post-herpetic patients, since both seizures and pain involve abnormally increased firing of nerve cells. Some of the commonly used medications are Pregabalin, Gabapentin and Carbamazepine.

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Pregabalin (pre-GAB-a-lin) is an anticonvulsant drug prescribed for the management of neuropathic pain associated with diabetic peripheral neuropathy (DPN), post-herpetic neuralgia (PHN) and epilepsy.

Opioid Analgesia

Opioids are morphine like drugs, typically defined as strong pain medications prescribed for all types of pain. Examples of opioids include Oxycodone, Buprenorphine, Morphine, Tramadol and Methadone. Studies have shown that opioids may effectively treat post-herpetic neuralgia without the cognitive side effects associated with anti-neuropathic medication.