Can Gabapentin Prevent Postherpetic Neuralgia & What Else Helps?
Postherpetic neuralgia is a complication of shingles. It is seen very commonly as an aftermath in people suffering from shingles. It results in agonizing and severe pain in the area where the shingles rashes developed. The pain continues for a long time even after the rashes of shingles disappear.
Can Gabapentin Prevent Postherpetic Neuralgia?
According to a study conducted in Texas, gabapentin may be helpful in preventing postherpetic neuralgia, if it is given at the time when acute herpes zoster occurs in patients. The researchers in this study claim that if gabapentin is administered along with the standard protocol of antiviral therapy and analgesics in persons with moderate to severe herpes zoster infection, it may be helpful in preventing postherpetic neuralgia. They insist that it is especially important to start doing this in those patients who are significantly at a higher risk of developing postherpetic neuralgia.
- The patients chosen for the study were given a 1000 mg of Valacyclovir thrice a day for a week and gabapentin was given at an initial dose of 300 mg every day. This dosage of gabapentin was titrated for up to a maximum dosage of 3600 mg for 4 weeks.
- Those who reported mild to no pain, gabapentin was discontinued in them at the completion of 4 weeks, after tapering for 1 week
- Those with moderate or higher pain were given gabapentin for 4 more weeks and then the dose was tapered for 1 week and discontinued
- Gabapentin was not given past 9 weeks in any of the patients
- The researchers found that less and less number of patients reported pain over the completion of treatment with gabapentin
- They also found that this significantly helped in improving the quality of life on those patients
The study particularly proved and stated that gabapentin did not mask the pain of postherpetic neuralgia, but, it prevented postherpetic neuralgia in the first place However, they also suggest that more studies are needed to prove the efficacy of gabapentin in preventing postherpetic neuralgia
They strongly recommend though, that gabapentin should be used in patients with herpes zoster, especially so in those who are at higher risk of developing postherpetic neuralgia, along with the standard antiviral and analgesic treatment regime.(1)
What Else Helps In Preventing Postherpetic Neuralgia?
In order to prevent postherpetic neuralgia, it is essential to prevent shingles. Doctors urge people, especially above 50 years of age, to get themselves vaccinated with Shingrix.
- This is essential even if they have had shingles already or have taken Zostavax.
- Shingrix is to be taken in two doses, which are given at a gap of 2 to 6 months apart
- Shingrix is believed to be more effective than Zostavax in terms of prevention of shingles
- However, Zostavax may still be recommended sometimes in some people.(2)
Postherpetic neuralgia cannot be cured, but symptoms, especially pain, can be relieved with treatment. In most cases, postherpetic neuralgia gets better with time.
For treating postherpetic neuralgia, more than one treatment methods are usually required, as it is seen that only one of the methods fails to give promising results. The treatment options may include-
- Lidocaine skin patches
- Capsaicin skin patch
- Opioid pain relievers
- Injectable steroids
All these treatment methods have their merits and demerits. Some of them may give you serious, unwanted side effects and hence should never be used without proper consultation with the doctor. Some of the methods, like capsaicin patches, are to be performed by an expert only. Also, some of the treatment methods may give you hazardous effects while used long- term. It is always recommended that you consult with your doctor prior to starting any treatment or medications.
Gabapentin may be useful in preventing postherpetic neuralgia, though more studies are required to establish the fact.