Utilisation of Oxcarbazepine in the Treatment of Postherpetic Neuralgia

Abstract

Background: Postherpetic neuralgia is a chronic, intense neuropathic pain syndrome that occurs as a complication of acute herpes zoster infection. To date, various drugs, including topical and oral analgesics, opioids, antidepressants, and antiepileptics, have been used in its treatment either as monotherapy or polytherapy.
Objective In the present study, we have investigated the effects ofa new antiepileptic agent oxcarbazepine tor postherpetic neuralgia.
Material and Methods: Oxcarbazepine was initiated in two equal doses orally in patients diagnosed as postherpetic neuralgia via anamnesis, physic and neurological examination, LANSS (Leeds Assessment of Neuropathic Symptoms and Signs Scale), and VAS (Visual Analogue Scale). Maximum tolerated dose (600-1500 mglday) was reached within the first four weeks, and stable dose was maintained during the following four weeks, after which medication was gradually lessened and finally withdrawn until the pain ceased.
Results: Twenty-one patients were included in the study of them, 12 were females and 9 were males, with an average age range of 39-82. Postherpetic neuralgia onset of the patients was 7 weeks on average. Oxcarbazepine of 900 mglday was initiated in patients with diffuse, severe, continuous, spontaneous, burning and throbbing pain, and in those with allodynia and LANSS scores of 20 to 24. The dose of maximum effect, 1500 mglday, was reached within the first four weeks, and the stable dose of 900 mglday was maintained during the next four weeks. Patients with allodynia with LANSS scores ranging between 16 and 19 were applied 900 mg/day oxcarbazepine. The dose of maximum effect, 1200 mglday was reached within the first four weeks, and the stable dose of 900 mg/day was preserved during the following four weeks. in patients without allodynia having LANSS scores of 16-19 were started with 600 mglday of oxcarbazepine. The dose of maximum effect, 900 mglday, was reached within the first four weeks, and the stable dose of 600 mglday was maintained during the next four weeks. For those with LANSS scores ranging from 12 to 15, ocarbazepine dose of 300 mg/day was initiated. The dose of maximum effect, 600 mglday, was reached within the first four weeks, and the stable dose of 600 mglday was maintained during the next four weeks. A regression of 53% at the eighth week was observed when all patients in our study group were examined. Regression value at the end of eighth week for the patients with allodynia was 52.3%. it was defined that the pain ceased in all patients at the end of the average 13.3 treatment weeks. Conclusions: As a result, okscarbazepine was noted to be effective in postherpetic neuralgia treatment and increases the quality of life. Given its effects and tolerability results, okscarbazepine can be used as a first­stage therapy in postherpetic neuralgia treatment.