Treatment Response in Antidepressant-Naïve Postherpetic Neuralgia Patients: Double-Blind, Randomized Trial

Neuropathic pain: a practical guide for the clinician

“…For example, 3 comparative RCTs suggest that analgesia with desipramine 109,110 or nortriptyline 111 is comparable to that of amitriptyline but with fewer side effects. Other studies suggest that opioids may be more efficacious than tricyclic antidepressants 112 or gabapentin 16 and that gabapentin is comparable to amitriptyline 113 and venlafaxine analgesia is comparable to that of imipramine.…”

Zoster-Associated Pain and Post Herpetic Neuralgia

“…Nortriptyline and desipramine are generally preferred to amitriptyline because of lower incidence of anticholinergic side effects such as sedation, orthostatic hypotension, cognitive decline, and constipation (Watson et al, 1998). Furthermore, despite amitriptyline is probably the most widely studied TCA for the treatment of PHN, nortriptyline and desipramine have recently been shown to be equally effective (Watson & Oaklander, 2002;Hempenstall et al, 2005;Rowbotham et al, 2005). A limiting factor in the clinical use of TCAs is represented by their side effects, including dry mouth, fatigue, dizziness, sedation, constipation, urinary retention, and palpitations.…”

Postherpetic neuralgia: epidemiology, pathophysiology and management

“…In a recent study investigating the efficacy of amitriptyline, desipramine and fluoxetine in antidepressant-naive PHN patients, all three drugs showed meaningful pain reduction, with desipramine and amitriptyline showing superior efficacy and tolerance compared with fluoxetine [99]. Looking at all the studies together, the average daily drug doses were 65-73 mg for amitriptyline, 89 mg for nortriptyline and 63-167 mg for desipramine.…”