Oxycodone Effective for Postherpetic Neuralgia

ROCHESTER, NY — Oxycodone is effective for treating postherpetic neuralgia, according to a study published in the April issue of the journal Pain. The study is one of the first to carefully evaluate different methods to relieve pain during a course of shingles, which many patients say causes the worst pain they have ever experienced.
“Oftentimes patients are told that the rash will heal in 2 or 3 weeks anyway, and the pain will go away, so they’re not given something for the pain unless it’s excruciating,” said lead author Robert Dworkin, PhD, University of Rochester Medical Center, Rochester, New York. “But moderate pain can stop people from working, or enjoying their hobbies, and it can also make some people depressed or anxious. So there’s good reason to treat all pain from the infection.” Dr. Dworkin and colleagues studied the effectiveness of oxycodone in 87 patients (mean age, 66 years) with shingles who had moderate to severe pain. Patients were randomised to receive oxycodone, gabapentin, or a placebo. All patients also received an antiviral medication. Patients taking oxycodone were more than twice as likely to experience a meaningful reduction in their pain — at least a 30% decrease — compared with those taking placebo. Though the medication was effective, nearly one-third of the participants on oxycodone withdrew from the study, mainly because of problems with constipation. Gabapentin did not appear useful to treat pain. Dr. Dworkin said it’s possible that a higher dose would be necessary to adequately treat shingles pain. But the medication must be increased over the course of 3 weeks or more, which is often too long to have much of an effect on a fast-moving infection like shingles that can run its course in a few weeks. SOURCE: University of Rochester Medical Center.

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