Treatment of postherpetic neuralgia

Abstract

Objective: To review treatment options for postherpetic neuralgia (PHN).

Data sources: Clinical literature selected by the authors accessed via MEDLINE. Search terms included postherpetic neuralgia, capsaicin, antidepressants, anticonvulsants, and lidocaine.

Study selection: Controlled trials relevant to PHN.

Data synthesis: Traditional analgesics offer little benefit for the treatment of PHN. The best results for pain relief have come from capsaicin and tricyclic antidepressants. Anticonvulsants have also been used, although the number of studies evaluating this is limited. More invasive therapies, such as transcutaneous electrical nerve stimulation and nerve blocks, can be considered if other therapies fail.

Conclusion: Early diagnosis and treatment of herpes zoster may offer patients the best chance of preventing the development of PHN. However, if PHN does develop, the patient should seek treatment early for the best chance of pain relief.