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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Herpes Zoster affecting forehead. Lidocaine patches, Capasaicin Cream treatment essential? Take anti-depressants?

Hello, I had Herpes Zoster affecting left side of forehead , eye lid, and left side of the nose. Diagnosis was done on 6th July, 2012. Doctor gave me following medicines : Famtrex 500 mg thrice a day for 15 days (July 6 to July 20); Zeptol 200 mg thrice a day for 30 days (July 6 to August 3); Omnacortil 50 mg once a day for 10 days (July 6 to July 16); then 40 mg once a day for 5 days (July 17 to July 22); then 20 mg per day for 6 days (July 23 to July 29); then 10 mg per day for 5 days (July 30 to August 3); then stopped; Acivir Cream for local application After this treatment, i had severe electric shock like pain and burning sensations in the affected regions. The diagnosis was Post Herpetic Neuralgia . Doctor gave me following medicines : Zeptol 400 mg once a day from 4th August (still continuing); Prothidex 50 mg once a day from 4th August (still continuing); Cetzin 5 mg once a day (still continuing); Atarax 25 mg twice a day (still contiunuing); Though the pain reduced slightly, but i am still having severe pain and much discomfort. On 6th August, doctor has prescribed Capsain-P gel alternatively Capsidol gel. I amk applying Capsidol from 6th August. From internet research I found that the treatment for Post Herpetic Neuralgia consists of the following treatment : 1. Anti Convulsants like Gabapentin ( Neurontin ) 2. Anti Depressant like Nortriptyline or Amitriptyline 3. Opiod Analgesics like tramadol or morphin 4. Lidocaine patches 5. Capasaicin Cream My questions are : 1. Why my doctor has not given me any of above medicines generally recommended in post herpetic neuralgia ? Are Zeptol and Prothidex sufficient to treat post herpetic neuralgia? 2. If any Anti Convulsant and Antidepressant is to be taken, whether they should be taken in combination or only one of the two should be taken.; and for how long Thanks very much. I will be grateful for your reply at the earliest. Rakesh My email address is : YYYY@YYYY
Mon, 27 Aug 2012
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Pathologist and Microbiologist 's  Response
Hello and thanks for posting your query on HCM
Yes the medications you mentioned are used for post herpetic neuralgia.
They act by reudcing the severe pain associated with the condition.
Continue your treatment for the required time period and see the results.
If the symptoms are not relieved after copletion of the course then consult your doctor.

I think this is the best way.
Trust your doctor. He knows your condition the best as he has examined you and prescribed the medicine.

Thanks and take care
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