title: Amitriptyline, but not lorazepam, relieves postherpetic neuralgia.
abstract: In a double-blind, randomized, crossover study, 58 patients with postherpetic neuralgia received 6-week courses of amitriptyline, 12.5 to 150 mg/d; lorazepam, 0.5 to 6 mg/d; or lactose placebo. Doses were titrated to the maximum level tolerated. Patients rated pain in a diary, using lists of verbal descriptors. Forty-seven percent of patients reported moderate or greater relief with amitriptyline, 16% with placebo, and 15% with lorazepam. Mean amitriptyline dose was 65 mg/d. Greater relief was associated with higher amitriptyline doses, up to the maximum dose of 150 mg/d, and with higher serum tricyclic levels. Lorazepam did not relieve pain and was associated with severe depressive reactions in four patients.
authors.affiliation: Neurobiology and Anesthesiology Branch, National Institute of Dental Research, Bethesda, MD 20892.
authors.forename: M B
authors.initials: MB
authors.lastname: Max
authors.forename: S C
authors.initials: SC
authors.lastname: Schafer
authors.forename: M
authors.initials: M
authors.lastname: Culnane
authors.forename: B
authors.initials: B
authors.lastname: Smoller
authors.forename: R
authors.initials: R
authors.lastname: Dubner
authors.forename: R H
authors.initials: RH
authors.lastname: Gracely
mesh_terms: D000328:Adult; D000368:Aged; D000639:Amitriptyline / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006562:Herpes Zoster / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008140:Lorazepam / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000188:drug therapy* / Q000209:etiology; D010919:Placebos; D011897:Random Allocation
chemical_list: D010919:Placebos; D000639:Amitriptyline; D008140:Lorazepam