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Treatments and drugs
By Mayo Clinic staffThere is no single treatment that relieves postherpetic neuralgia in all people. In many cases, it may take a combination of treatments to reduce the pain.
Lidocaine skin patches
These are small, bandage-like patches that contain the topical, pain-relieving medication lidocaine. These patches can be cut to fit only the affected area. You apply the patches, available by prescription, directly to painful skin to deliver temporary relief.
Tricyclic antidepressants
Antidepressants such as nortriptyline and amitriptyline affect key brain chemicals that play a role in both depression and how your body interprets pain. Doctors typically prescribe antidepressants for postherpetic neuralgia in smaller doses than they do for depression.
Certain anticonvulsants
Anti-seizure medications also can lessen the pain associated with postherpetic neuralgia. These medications stabilize abnormal electrical activity in your nervous system caused by injured nerves. Doctors may prescribe gabapentin (Neurontin), pregabalin (Lyrica) or another anticonvulsant to help control burning and pain.
Opioid painkillers
Some people may need prescription-strength pain medications containing tramadol (Ultram, Ryzolt), oxycodone (Percocet) or morphine. However, these drugs can be addictive. Although this risk is generally low, discuss it with your doctor.
- Bajwa ZH, et al. Postherpetic neuralgia. http://www.uptodate.com/home/index.html. Accessed March 11, 2010.
- Sampathkumar P, et al. Herpes zoster (shingles) and postherpetic neuralgia. Mayo Clinic Proceedings. 2009;84:274.
- Treatment of postherpetic neuralgia. In: Habif TP. Clinical Dermatology. 5th ed. Philadelphia, Pa.: Mosby Elsevier; 2009. http://www.mdconsult.com/book/player/book.do?method=display&type=bookPage&decorator=header&eid=4-u1.0-B978-0-7234-3541-9..00021-3--s0825&displayedEid=4-u1.0-B978-0-7234-3541-9..00021-3--s0845&uniq=188689159&isbn=978-0-7234-3541-9&sid=966992901#lpState=opened&lpTab=contentsTab&content=4-u1.0-B978-0-7234-3541-9..00021-3--st0755%3Bfrom%3Dcontent%3Bisbn%3D978-0-7234-3541-9%3Btype%3DbookPage. Accessed March 12, 2010.
- Vora A, et al. Postherpetic neuralgia. In: Frontera WR, et al. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/188689159-4/966996765/1678/116.html#4-u1.0-B978-1-4160-4007-1..50103-6_1654. Accessed March 12, 2010.
- Martin DM (expert opinion). Mayo Clinic, Rochester, Minn. March 22, 2010.
- Practice parameter: Treatment of postherpetic neuralgia. St. Paul, Minn.: Quality Standards Subcommittee of the American Academy of Neurology. http://www.guidelines.gov/summary/summary.aspx?doc_id=5989&nbr=003947&string=postherpetic. Accessed March 12, 2010.
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