Post-Herpetic Neuralgia: A Review of Advances in Treatment and Prevention
November 2006 | Volume 5 | Issue 10 | Original Article | 938 | Copyright © November 2006
Lorraine Young MD
Post-herpetic neuralgia (PHN) is primarily a disease of the elderly and often refractory to treatment. Randomized and controlled
trials have yielded several significant advances in the treatment and prevention of this disease. Treatment advances
include the lidocaine patch, opioid analgesics, nortriptyline, amitriptyline, and gabapentin. However, no treatment regimen
fully eliminates the pain. Improvements in prevention include prompt recognition and treatment of high-risk herpes zoster
(HZ) patients with antiviral and analgesic therapies. Even with these advances, PHN remains a debilitating and painful disease.
Vaccines offer the greatest promise of relief. The childhood vaccine against varicella zoster virus offers long-lasting
immunity, largely preventing HZ and PHN. But most adults have already had varicella and are at risk for HZ and PHN as
they age. Therefore, a more potent vaccine against varicella has been developed for use in adults. This vaccine offers a new
and significant advance in the prevention of HZ and its most noteworthy complication, PHN.