Case report of patient with post herpetic neuralgia successfully treated with medication
A 57 year old gentleman with post herpetic neuralgia attended the clinic. He was taking Gabapentin 400 mg t.d.s. and was on Amitriptyline 100 mg. Unfortunately, he was getting little benefit from this and we decided to stop the Gabapentin.
We started him on Pregabalin 150 mg twice per day, Amitriptyline 25 mg nocte and Oxycodone 5 mg as required. He was given full information about the potential adverse effects of the medications and, in particular, using them in combination.
New medication regimen for post herpetic neuralgia
He was reviewed 2 weeks later and I am pleased to say that he had great benefit with the new regime. Unfortunately, he was unable to take the Amitriptyline as this made him excessively sleepy. He also found the Oxycodone helpful, particularly with sleep.
We decided to give him Carbamazepine 100 mg nocte and Tramadol 25 mg as required, and booked him in for a course of 6 stellate ganglion nerve blocks. He will be reviewed in approximately one month’s time.