Analgesics
Capsaicin (Zostrix-HP), an extract from hot chili peppers, is more efficacious for post-herpetic neuralgia than placebo. Capsaicin cream must be applied to the affected area three to five times daily.
Lidocaine patches reduce pain intensity, with minimal systemic absorption. The effect lasts only four to 12 hours with each application.
Acetaminophen (eg, Tylenol) and nonsteroidal anti-inflammatory drugs are useful for potentiating the pain-relieving effects of other agents.
Tricyclic antidepressants that are commonly used in the treatment of postherpetic neuralgia include amitriptyline Elavil, nortriptyline (Pamelor), imipramine (Tofranil) and desipramine (Norpramin).
Anticonvulsants. Phenytoin Dilantin carbamazepine (Tegretol) and gabapentin Neurontin are often used to control neuropathic pain.
Other modalities used to treat post-herpetic neuralgia include transcutaneous electric nerve stimulation (TENS), biofeedback and nerve blocks.