Efficacy of low dose gabapentin in acute herpes zoster for preventing postherpetic neuralgia: a prospective controlled study

Abstract

Postherpetic neuralgia (PHN) is a sequela of herpes zoster that adversely affects quality of life seriously. The risk factors for PHN are well known but the effective interventions that reduce the incidence of PHN are less studied. The objective of this study is to evaluate the efficacy of treatment with gabapentin in patients with acute herpes zoster for preventing PHN. We performed a prospective randomized controlled study of 120 participants diagnosed with acute herpes zoster, aged 50 and over and complaining moderate to severe pain. All patients were treated with valacyclovir and acetaminophen. Half of the participants were assigned to the gabapentin group and received gabapentin 300 mg three times a day additionally. The intensity of pain at every visit and the incidence of PHN in both groups were measured. Total 52 and 49 patients in the gabapentin group and the control group, respectively, had completed 12 weeks of follow-up period. Although the incidence of PHN was higher in the control group, the difference was not statistically significant (6.1% vs. 3.8%, p = 0.67). Our results indicate that the use of low-dose gabapentin in acute herpes zoster seems not effective in the prevention of PHN.

Efficacy of gabapentin for the prevention of postherpetic neuralgia in patients with acute herpes zoster: A double blind, randomized controlled trial

“…We also found that gabapentin did not improve QoL (measured by the SF-12) or sleep quality (measured by the MOS- sleep scale). This is similar to the results of a previous trial, which reported that gabapentin had no significant effect on Dermatological Quality of Life scores [36]. In our study, patients who received gabapentin had significantly poorer scores in the SF-12 domains of physical functioning, role physical, role emotional, mental health, and bodily pain.…”

“…Another study that evaluated the efficacy of gabapentin during the acute herpetic infection phase had results similar to ours[36]. This RCT examined 120 participants with HZ within 4 days of rash onset and with pain scores of 4 on a 10-point Likert scale.…”

Efficacy of gabapentin for prevention of postherpetic neuralgia: study protocol for a randomized controlled clinical trial

“…A prospective controlled study showed that low doses of gabapentin were not effective in the prevention of PHN [9]. However, the study was nonrandomized, and patients were not blinded to treatment.…”

“…Researchers in an uncontrolled, open-label study reported that administration of gabapentin plus valacyclovir during the acute phase of HZ infection reduced the incidence of PHN [8]. A more recent prospective, controlled, two-armed study using low doses of gabapentin and valacyclovir showed no statistical differences between the two groups regarding PHN prevention [9]. …”

Infection, Pain, and Itch

“…For example, HSV1 reactivation causes painful ''cold sores'' during reactivation. VZV, the causative agent of shingles, produces significant acute pain during primary infection and can also induce neuropathic pain leading to post-herpetic neuralgia, a chronic, intractable pain [43][44][45]. Postherpetic neuralgia is a significant complication in people over the age of 60, necessitating vaccination against VZV in geriatric populations [46].…”