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Drugs & Aging

, Volume 31, Issue 9, pp 653–660 | Cite as

Antiepileptics for Post-Herpetic Neuralgia in the Elderly: Current and Future Prospects

  • Gisèle Pickering
Leading Article

Abstract

Post-herpetic neuralgia is a painful condition and its prevalence increases with age. It is a burden for older patients and the association of age-related pharmacokinetic and pharmacodynamic changes, high co-morbidity and polypharmacy leads to the risk of adverse drug reactions and interactions. This type of neuropathic pain is particularly difficult to treat and guidelines recommend the use of gabapentinoids and some antidepressants, the utility of which may be hampered by adverse effects such as sedation, dizziness and impaired age-related renal function. Re-formulations of antiepileptics (anticonvulsants) are being developed and/or marketed and suggest interesting innovative profiles with improved bioavailability, low drug–drug interactions and better tolerability that need to be confirmed in future studies. However, there are no new antiepileptics being developed for post-herpetic neuralgia, and prospective studies specifically focused on the older population are still missing, while this age group is particularly at risk of developing shingles and chronic neuropathic pain with a deleterious impact on quality of life.

Keywords

Neuropathic Pain Gabapentin Pregabalin Duloxetine American Geriatrics Society 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

No conflict of interest to declare.

No source of funding to declare.

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Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  1. 1.CHU Clermont-Ferrand, Centre de Pharmacologie CliniqueClermont-FerrandFrance
  2. 2.Inserm, CIC 1405, Neurodol-1107Clermont-FerrandFrance
  3. 3.Laboratoire de Pharmacologie, Faculté de médecineClermont UniversitéClermont-FerrandFrance
  4. 4.Clinical Pharmacology CentreBâtiment 3C, CHU, Hopital G MontpiedClermont-Ferrand CedexFrance

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