Amitriptyline versus placebo in postherpetic neuralgia

Area of Science:

• Neurology
• Pharmacology

Background:

• Postherpetic neuralgia is a chronic neuropathic pain condition.
• Limited effective treatments exist for postherpetic neuralgia.

Purpose of the Study:

• To evaluate the efficacy of amitriptyline in treating postherpetic neuralgia.
• To determine if amitriptyline's effects are related to its antidepressant properties.

Main Methods:

• A double-blind, placebo-controlled crossover study was conducted.
• 24 patients with postherpetic neuralgia were randomly assigned to amitriptyline or placebo.
• Pain relief and antidepressant effects were assessed.

Main Results:

• 16 out of 24 patients experienced good to excellent pain relief (p ≤ 0.001).
• Amitriptyline did not show significant antidepressant effects in most patients (p > 0.05).
• Median effective dose was 75 mg, with median blood levels of 65 ng/mL for amitriptyline and 30 ng/mL for nortriptyline.

Conclusions:

• Amitriptyline is a useful treatment for postherpetic neuralgia pain.
• The analgesic effect may be independent of its antidepressant action.