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Postherpetic neuralgia Rx

Treatment options for post-herpetic neuralgia include TCAs (amitriptyline, nortriptyline, desipramine and imipramine), serotonin noradrenaline reuptake inhibitors (venlafaxine and duloxetine), selective serotonin reuptake inhibitors (data are conflicting), gabapentin and pregabalin (may improve both pain and quality of life), oxycodone and tramadol, as well as 5% lidocaine patches and topical capsaicin (neither of which should be used as a sole agent). Note that the data supporting antiepileptic drugs is mostly in the realm of painful diabetic neuropathy.


  1. Che S Zin, Lisa M Nissen, Maree T Smith, James P O’Callaghan, Brendan J Moore An update on the pharmacological management of post-herpetic neuralgia and painful diabetic neuropathy. CNS Drugs: 2008, 22(5);417-42 PubMed Link