It can also lead to further problems, including extreme tiredness, sleeping difficulties and depression. Living with post-herpetic neuralgia can be very difficult because it can affect your ability to carry out simple daily activities, such as dressing and bathing. The National Institute for Health and Care Excellence (NICE): questions to ask about drug treatments for neuropathic pain Living with post-herpetic neuralgia
These can be started by a GP but may need to be reviewed by a pain specialist. If these medicines do not help, they should be stopped.
If other medicines have not helped, stronger painkillers, such as morphine-based medicines, may be recommended. Tramadol can be addictive if taken for long periods, so it should be prescribed for the shortest time possible and stopped if it does not help. While waiting for your appointment, you might be offered a medication called tramadol. If your pain gets worse despite treatment, you may be referred to a specialist pain clinic to treat post-herpetic neuralgia. If effective, the treatment can be repeated, usually every few months depending on how your symptoms have improved. They're available at specialist pain clinics and are applied as a single treatment in the clinic or at hospital. High-strength capsaicin patches can also be used to treat post-herpetic neuralgia. It works by changing the way the nerve endings function. You apply it to the affected area a few times a day, but only when the rash has healed. It can stop the nerves sending pain messages to the brain. Your GP can prescribe capsaicin as a low-dose cream for nerve pain. They cannot be used for more than 12 hours at a time. They can be useful when pain affects sleeping or daytime activity. Lidocaine plasters are sticking plasters that contain a local anaesthetic. Or your GP may prescribe them to use with other medicines if your pain is severe. Your GP may recommend these treatments if your pain is mild or if you cannot take antidepressants or anticonvulsants. Your GP can prescribe treatments that you apply directly to the painful area. Creams and plasters for post-herpetic neuralgia If these medicines still do not help after several weeks, or if they're causing significant side effects, your dose will need to be gradually reduced. Possible side effects can include dizziness, drowsiness, poor memory, increased appetite and weight gain. Not everyone gets side effects when taking gabapentin and pregabalin. They also usually need to be taken for a few weeks before they start to take effect. Like the antidepressants used for post-herpetic neuralgia, they should be started at a low dose, which is gradually increased over a few days or weeks. Gabapentin and pregabalin are the two main anticonvulsants prescribed for post-herpetic neuralgia. If these medicines still do not help after several weeks, or if they're causing significant side effects, your dose will need to be gradually reduced to prevent withdrawal effects.
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It may take a few weeks to feel the full effects.Ĭommon side effects include a dry mouth, constipation, dizziness and drowsiness. You'll usually be started on a low dose, which may be increased depending on the benefits and side effects.
AntidepressantsĪmitriptyline and duloxetine are the two main antidepressants prescribed for post-herpetic neuralgia. Some medicines used to treat depression also work for nerve pain, so you may be advised to try one of these. But your GP may suggest using paracetamol or a combination of paracetamol and codeine initially to see if it has an effect. You may need to try a number of different types of medicine to find the one, or combination, that works best for you.Ĭommonly used painkillers do not usually work for post-herpetic neuralgia. Medicines may not stop the pain completely, but they can help reduce it.
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