Comparison of amitriptyline and carbamazepine effectiveness in the treatment of postherpetic neuralgia
Keywords:
Postherpetic neuralgia, Herpes zoster ophthalmicus, visual analog scale, carbamazepine, amitriptylineAbstract
Intoduction Postherpetic neuralgia (PHN), a chronic and debilitating pain condition, is caused by acute herpes zoster lesions. It affects the patient’s daily activities, sleep, social well-being, and quality of life (QoL). The mainstays of its treatment are systemic medications such as tricyclic antidepressants and antiepileptics.  Objective To determine the effectiveness of carbamazepine and amitriptyline in the management of PHN.  Methods In this study, amitriptyline and carbamazepine were given to PHN patients who met the inclusion criteria at Khyber Teaching Hospital in Peshawar. Patients were separated into two groups after written informed consent, a physical examination, and relevant investigations. Group A received 25mg amitriptyline at night time and Group B received 200 mg carbamazepine two times daily for eight weeks. The severity of the pain and the effectiveness of the therapy was assessed using a visual analogue scale (VAS score). SPSS 23 was used to analyzed the data.  Results There was no significant difference statistically in the age of patients (p=0.41), gender (p=0.40), duration of PHN (P=0.40), and pre-treatment VAS score (p=0.11). The effectiveness (good to excellent) of amitriptyline and carbamazepine was 86% and 80% respectively (p=0.66). Upon intragroup comparison, amitriptyline (p<0.001) and carbamazepine (p<0.02) were statistically significant in the reduction in PHN.  Conclusion Amitriptyline and carbamazepine reduce PHN-associated pain and discomfort. Both medications improve PHN patients' QoL, well-being, and physical functioning.References
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