Fast Five Quiz: Herpes Zoster Postherpetic Neuralgia

Jason F. Okulicz, MD


June 01, 2020

The goal of therapy for PHN is to reduce morbidity through the use of tricyclic antidepressant, anticonvulsant, anesthetic, analgesic, corticosteroid, and antiviral agents. Tricyclic antidepressants have central effects on pain transmission and block the active reuptake of norepinephrine and serotonin. These agents have been found to be useful for certain types of chronic and neuropathic pain. The most evidence has been found to support this particular class of antidepressant versus other classes in the treatment of PHN.

Anticonvulsant agents, such as pregabalin and gabapentin, manage severe muscle spasms and provide sedation in neuralgia. This class of agents has central effects on pain modulation.

Local anesthetic action can be achieved for the affected area using anesthetic agents, which render the neuron less permeable to ions, thereby preventing the initiation and transmission of nerve impulses.

Topical analgesic agents such as capsaicin help to desensitize skin and joints to pain. Most analgesic agents have sedating properties, which can be helpful in the treatment of pain.

Corticosteroids have anti-inflammatory properties and also modify the body's immune response to stimuli.

Antiviral agents can be used to shorten the clinical course of PHN, prevent complications, prevent latency and/or recurrence, decrease transmission, and eliminate established latency.

Learn more about medications that can be used to treat PHN.

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