Acute and postherpetic neuralgia in the elderly: analysis of evidence for therapeutic options].

Thomas Schmid, Sophie Pautex, Pierre-Olivier Lang

Service de médecine de premier recours, Département de médecine communautaire, de premier recours et des urgences, HUG, Genève.

Revue médicale suisse 2012 Jun 27

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Initiated within the first 72 hours of the rash, the aim of antiviral drugs prescribing is to reduce both acute neuralgia (AN) and later complications and especially postherpetic neuralgia (PHN). However their analgesic as well as preventative effect on AN and PHN is modest. With the lack of the preventive vaccine in Switzerland and in the absence of more effective antiviral drugs, combinations with analgesic drugs are often needed in pain management. However medication selection and prescribed dosage in the context of old patients' frailty, co-morbidities and often polypharmacy must be carefully considered. Based on analysing the evidences from the literature, this review presents the therapeutic options we have at one's disposal and proposes a stepwise management for both AN and PHN specifically designed for aged population.

Citation

Thomas Schmid, Sophie Pautex, Pierre-Olivier Lang. Acute and postherpetic neuralgia in the elderly: analysis of evidence for therapeutic options]. Revue médicale suisse. 2012 Jun 27;8(347):1374-8, 1380-2