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26-07-2023 | Gabapentin | Neuropathic Pain (A Abd-Elsayed, Section Editor)

Therapeutic Strategies for Postherpetic Neuralgia: Mechanisms, Treatments, and Perspectives

Authors: Jiayu Tang, Yunchao Zhang, Chenxin Liu, Anqi Zeng, Linjiang Song

Published in: Current Pain and Headache Reports | Issue 9/2023

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Abstract

Purpose of Review

Postherpetic neuralgia is an annoying pain that mainly affects older people. In order to give patients more options, this review summarizes the pharmacological and interventional treatments for postherpetic neuralgia and updates the research on the efficacy, thereby providing doctors with more treatment options. The adverse effects and effective doses of its various treatments are also presented so that the therapy can be prescribed according to their concrete physical conditions. In a word, this review is dedicated to providing a comprehensive overview of the treatment options for postherpetic neuralgia and offering patients more choices.

Recent Findings

Combinational therapy is more excellent than monotherapy. The local anesthesia and gabapentin comprised outstanding compatibility. In addition, two therapeutic tools for PHN patients, especially for the intractable ones, electroacupuncture (EA), and osteopathic manipulative treatment (OMT), show their efficacy and become potential options to alleviate pain.

Summary

In terms of treatment, guidelines recommend patients use tricyclic antidepressants (TCAs), gabapentin, pregabalin, and 5% lidocaine patches as the first-line medications, and gabapentin is investigated most, especially the gabapentin enacarbil (GEn). And drug efficacy can be limited by adverse effects and tolerated doses. Interventional treatments, with their invasiveness and operational difficulty, are usually considered for intractable patients. Combinational therapies may be used when a single therapy cannot achieve the desired effect. Therapies such as OMT and EA have also been proposed to palliate pain in some cases, and future directions of treatment may be investigated in Chinese medicine and acupuncture.
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Metadata
Title
Therapeutic Strategies for Postherpetic Neuralgia: Mechanisms, Treatments, and Perspectives
Authors
Jiayu Tang
Yunchao Zhang
Chenxin Liu
Anqi Zeng
Linjiang Song
Publication date
26-07-2023
Publisher
Springer US
Published in
Current Pain and Headache Reports / Issue 9/2023
Print ISSN: 1531-3433
Electronic ISSN: 1534-3081
DOI
https://doi.org/10.1007/s11916-023-01146-x

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