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

  • Neuropathic Pain (A Abd-Elsayed, Section Editor)
  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

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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Data Availability

It is not applicable.

Code Availability

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Funding

The work is supported by Xinglin project of Chengdu University of Traditional Chinese Medicine (ZKYY2019, MPRC2021012).

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  1. School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 611137, People’s Republic of China

    Jiayu Tang, Yunchao Zhang, Chenxin Liu & Linjiang Song

  2. Institute of Translational Pharmacology and Clinical Application, Sichuan Academy of Chinese Medical Science, Chengdu, Sichuan, 610041, People’s Republic of China

    Anqi Zeng

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L. S. and A. Z. were involved in the conception of the study. J. T., Y. Z., and C. L. were involved in writing the article. L. S. and A. Z. critically revised the manuscript. All authors contributed to the article and approved the submitted version.

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Correspondence to Anqi Zeng or Linjiang Song.

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Tang, J., Zhang, Y., Liu, C. et al. Therapeutic Strategies for Postherpetic Neuralgia: Mechanisms, Treatments, and Perspectives. Curr Pain Headache Rep 27, 307–319 (2023). https://doi.org/10.1007/s11916-023-01146-x

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