REVIEW PAPER
Post-herpetic neuralgia: currently available oral and topical medications in the management of pain – a review
1
Clinical Department of Internal Medicine, 4th Military Clinical Hospital, Wrocław, Poland
2
Clinical Department of Endocrinology, Metabolic and Internal Medicine, University Clinical Hospital, Poznań Poland
3
Internal Medicine Department, Rear Admiral Professor Wiesław Łasiński 7th Military Navy Hospital, Gdańsk, Poland
4
SPZOZ of the Ministry of Internal Affairs and Administration, Department of Internal Medicine and Geriatrics, Krakow, Poland
5
Department of Clinical Oncology, PCK Maritime Hospital, Gdynia, Poland
6
Department of Gastroenterology and Internal Medicine, Autonomous Public Provincial Polyclinical Hospital, Szczecin, Poland
Corresponding author
Damian Bęben
4th Military Clinical Hospital, Clinical Department of Internal Medicine, Weigla 5 Street, 53-114, Wrocław, Poland
4th Military Clinical Hospital, Clinical Department of Internal Medicine, Weigla 5 Street, 53-114, Wrocław, Poland
J Pre Clin Clin Res. 2024;18(2):162-167
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Post-herpetic neuralgia (PHN) is the most common chronic complication of herpes zoster and also one of the most troublesome. It is a prime example of typical neuropathic pain which in many cases contributes to a significant reduction in the patient’s quality of life. Despite the emergence of a prophylactic method in the form of a vaccine, PHN continues to be a significant problem, particularly affecting the elderly and immunocompromised individuals.
Objective:
The aim of this review is to summarize the knowledge contained in the current literature on the available oral and topical medications for the treatment of neuropathic pain in PHN. An area of particular focus was the effectiveness and safety of their use
Review methods:
The review is based on 49 scientific publications found in PubMed, PubMedCentral, NCBI and Via Medica Journals databases published between 2008–2024.
Brief description of the state of knowledge:
Current treatment of PHN is mainly based on pharmacological therapy. Both oral and topical drugs belonging to a variety of groups are used. Gabapentinoids, tricyclic anti-depressants and, in some circumstances, lidocaine 5% patches, are considered first-line medications. In contrast, capsaicin 8% and opioids are considered second-line medications. The use of multimodal therapy is becoming widespread due to the relatively frequent ineffectiveness of pain management during monotherapy.
Summary:
Despite the wide range of methods available for use in the treatment of neuropathic pain, management of PHN continues to be a challenging task. Multimodal therapy using medications with different mechanisms of action and an individualized approach to drug selection based on the specific clinical case are crucial for treatment success.
Post-herpetic neuralgia (PHN) is the most common chronic complication of herpes zoster and also one of the most troublesome. It is a prime example of typical neuropathic pain which in many cases contributes to a significant reduction in the patient’s quality of life. Despite the emergence of a prophylactic method in the form of a vaccine, PHN continues to be a significant problem, particularly affecting the elderly and immunocompromised individuals.
Objective:
The aim of this review is to summarize the knowledge contained in the current literature on the available oral and topical medications for the treatment of neuropathic pain in PHN. An area of particular focus was the effectiveness and safety of their use
Review methods:
The review is based on 49 scientific publications found in PubMed, PubMedCentral, NCBI and Via Medica Journals databases published between 2008–2024.
Brief description of the state of knowledge:
Current treatment of PHN is mainly based on pharmacological therapy. Both oral and topical drugs belonging to a variety of groups are used. Gabapentinoids, tricyclic anti-depressants and, in some circumstances, lidocaine 5% patches, are considered first-line medications. In contrast, capsaicin 8% and opioids are considered second-line medications. The use of multimodal therapy is becoming widespread due to the relatively frequent ineffectiveness of pain management during monotherapy.
Summary:
Despite the wide range of methods available for use in the treatment of neuropathic pain, management of PHN continues to be a challenging task. Multimodal therapy using medications with different mechanisms of action and an individualized approach to drug selection based on the specific clinical case are crucial for treatment success.
Bęben D, Kowalewski J, Recka K, Michałka D, Grzelak A, Jędrocha O, Godyńska S, Obacz E, Grodek Z, Miliwek J. Postherpetic neuralgia:
Currently available oral and topical medications in the management of pain – a review. J Pre-Clin Clin Res. 2024; 18(2): 162–167. doi: 10.26444/jpccr/189442
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