Questions from patients about analgesic pharmacotherapy and responses from authors are presented to help educate patients and make themmore effective self-advocates. The topic addressed in this issue is postherpetic neuralgia, symptoms, risk factors, and treatment.

N-methyl-D-aspartate (NMDA) receptor antagonists relieve neuropathic pain in animal models, but side effects of dissociative anesthetic channel blockers, such as ketamine, have discouraged clinical application. Based on the hypothesis that low-affinity NMDA channel blockers might have a better therapeutic ratio, we carried out two randomized, double-blind, crossover trials comparing six weeks o...

OBJECTIVE To compare the efficacy and safety of valacyclovir hydrochloride and famciclovir for the treatment of herpes zoster. DESIGN A double-blind, randomized, controlled, multicenter clinical trial in which patients received 7 days of treatment and were followed up for 24 weeks. SETTINGS Patients reported directly to specialist centers or were referred from primary care centers. PATIEN...

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The accurate diagnosis of postherpetic abdominal pseudohernia, the rare complication of herpes zoster, is essential to avoid unnecessary imaging studies or surgery. Close observation and waiting for complete recovery are warranted considering the disease's self-resolving nature and favorable prognosis.

An argument is presented here for postherpetic neuralgia as an intractable end-stage disorder for many patients. The exciting possibility of prevention of this disorder by early, aggressive treatment exists; however, the extent to which therapy can be effective is unknown. Early, aggressive treatment of the pain of herpes zoster is, nevertheless, urged, and the options for treatment are discuss...

Postherpetic neuralgia (PHN) is a form of refractory chronic neuralgia that, despite the importance of prevention, currently lacks any effective prophylaxis. The efficacy of live zoster vaccine in preventing PHN was recently reported [1]. However, this vaccine appeared to be of limited use in prophylaxis[2]. PHN has a variety of symptoms and significantly affects patient quality of life [3-12]....

Postherpetic neuralgia remains a therapeutic challenge for the clinician. Many modalities have been utilized with limited success. In this pilot randomized study of patients who were refractory to previous medicinal treatment, the patients were treated with transcutaneous nerve stimulation with a biofeedback capability. After every two treatments with the sham and true device, the patients were...