Comparison of Pregabalin and Nortriptyline on Efficacy and Safety in Postherpetic Neuralgia

Abstract

Objectives: Antidepressants and anticonvulsants are most commonly prescribed in postherpetic neuralgia (PHN). The aim of the present study was to compare the efficacy and safety of pregabalin and nortriptyline in patients of PHN.
 Methods: The present study was conducted in 48 patients of PHN attending outpatient department of Dermatology, GMC Jammu. After obtaining written consent, the enrolled patients were randomized into two groups, one group was given pregabalin 150 mg orally per day, and other group was treated with nortriptyline 25 mg orally per day and were followed up to 8 weeks. Patients were assessed on numerical rating scale (NRS), Leeds assessment of neuropathic symptoms and signs (LANSS). Safety of the drugs was monitored by adverse drug reactions (ADRs).
 Results: All patients were over 57 years and thoracic dermatome was most affected. Both drugs significantly reduced NRS and LANSS (p<0.0001). However, on comparison pregabalin was found to be better than nortriptyline at 8 weeks on mean NRS (p= 0.0073), LANSS (p=0.0032). Total of six mild ADRs occurred, two in group pregabalin and four in nortriptyline treated group.
 Conclusion: Both pregabalin and nortriptyline were effective in patients of PHN, but pregabalin was found to be better than nortriptyline at 8 weeks. Both drugs were well tolerated, though pregabalin had lesser number of ADRs.