Postherpetic Neuralgia Treatments

There are a number of effective postherpetic neuralgia treatments your doctor can prescribe. The most successful treatments are anti-seizure medications, anti-viral agents, anti-depressants, and opioid pain relievers. Patches containing lidocaine, or other pain relievers, are also remarkably effective.

Before you try any treatment for PHN, ensure that PHN is the correct diagnosis; perhaps get a second opinion. It sounds obvious, but treatment is only effective when it’s for the correct diagnosis.

In-depth Articles on Postherpetic Neuralgia Treatments

Anti-depressant and Anti-epileptic Medications as Postherpetic Neuralgia Treatments
If your doctor prescribes an anti-depressant while you are battling postherpetic neuralgia, he or she is probably not treating you for depression. Tricyclic anti-depressants, such as amitriptyline, nortriptyline, and desipramine are effective at treating postherpetic neuralgia pain. Other classes of anti-depressant are also helpful. All classes of anti-depressant take a few weeks to start working, so be patient.

Recently, gabapentin enacarbil (Horizant) was approved by the FDA for the treatment of PHN in adults. These are extended-release tablets that can help manage the painful symptoms of PHN. Pregabalin, gabapentin, and carbamazepine, which are anti-seizure (anti-epileptic) medications, can also help with your postherpetic neuralgia pain. Even though these medications initially came on the market to treat epilepsy and other seizure conditions, researchers eventually discovered how much they help relieve nerve pain.

The medical community thinks anti-epileptic and anti-depressant medications help reduce the chaos your nerves are experiencing after sustaining damage from shingles. Once your nerves are calmed, they can heal, and your pain decreases.

Treating PHN with Anti-viral and Pain Medications
The anti-viral drugs valacyclovir and acyclovir are also becoming medications of choice for treating postherpetic neuralgia. In recent clinical trials, patients receiving these anti-viral drugs had their pain go away faster than those who did not receive them. They were also more likely to be pain free after 6 months.1

Traditional opioids, such as morphine, methadone, hydromorphone, oxycodone, and tramadol, are also frontline postherpetic neuralgia treatments. They relieve pain about 30 minutes after taking the pills.

Lidocaine Patches for Postherpetic Neuralgia
Lidocaine patches are FDA-approved to treat PHN. The medication in the patch—lidocaine—can penetrate your skin and go to the nerves that are sending the pain signals. A benefit of lidocaine patches is that they don't numb the skin.

Steroid Injections for PHN
Steroids administered by a shot into your spine are another treatment option. However, this treatment is usually reserved for patients who continue to have postherpetic neuralgia pain after a year, and they begin to develop inflammation in their spine.

Secondary Treatments for Postherpetic Neuralgia
In cases where the main treatments listed above fail to provide you enough relief, there are other treatments that may help.

Aspirin-based creams may relieve pain-afflicted skin. Creams that contain capsaicin—the same chemical that makes a chili pepper hot—can send soothing messages to distressed nerves in your skin.

There are a few less-proven treatments that seem to help some postherpetic neuralgia patients. Nevertheless, in medical studies there is only questionable evidence about their effectiveness. Some of these treatments include:

  • creams containing the steroid benzydamine
  • the cough medicine dextromethorphan
  • the non-steroidal anti-inflammatory drug (NSAID) indomethacin
  • acupuncture
  • applying the cancer drug vincristine on and around painful skin
  • mexiletine, an oral form of lidocaine

If you are suffering a great deal, even after trying some of the main treatments for postherpetic neuralgia, you and your doctor may consider some of these other PHN treatments. They may work well for you, even though they did not work well in clinical studies.

While postherpetic neuralgia is a condition that is likely to trouble you for a few months, there are a number of treatment choices to reduce the stinging, soreness, and throbbing you feel. Some, such as anti-viral drugs, opioids, lidocaine pain patches, and anti-epileptic medications, will help reduce the pain right away. If you are patient for a few weeks, an anti-depressant can provide additional relief from PHN pain.

Updated on: 07/10/13
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