Amitriptyline and fluphenazine in the treatment of postherpetic neuralgia

Background: Postherpetic neuralgia (PHN) is a vexing problem occurring in 1 0 to 20 percent of people with from herpes tester (shingles). Anecdotal rep orts show that fluphenazine enhances the effects of amitriptyline for the t reatment of PHN. The aim of this study was to determine, in a controlled ma nner, whether this was the case. Methods: In a double-blind placebo-controlled study, 49 patients with PHN w ere randomly assigned to four treatment groups: Group 1, amitriptyline; Gro up 2, amitriptyline and fluphenazine; Group 3, fluphenazine; Group 4, a pla cebo. An active placebo was used to mimic the anticholinergic side effects of dry mouth. The study lasted 8 weeks, with weekly progress evaluations wi th use of visual analog scales (VAS), the McGill Pain Questionnaire (MPQ), and a side-effects scale. Results: A statistically significant decrease was seen in pain in Groups 1 and 2, and no significant changes were seen in Groups 3 and 4. There was no significant difference when fluphenazine was added to amitriptyline. Conclusion: These data support the effectiveness of amitriptyline in treatm ent of PHN, but do not support the addition of fluphenazine.