89 ACTA DERMATOVENEROLOGICA CROATICA Acta Dermatovenerol Croat 2012;20(2):89-94 CLINICAL ARTICLE Comparative Study of Clinical Eicacy of Amitriptyline and Pregabalin in Postherpetic Neuralgia Arun Achar 1 , Partha Pratim Chakraborty 2 , Samiran Bisai 3 , Asish Biswas 4 , Tapobrata Guharay 5 1 Department of Dermatology; 2 Department of Medicine, Midnapore Medical College Paschim Medinipur, West Bengal; 3 Society for Applied Studies, Salt Lake, Kolkata and Department of Anthropology, North Eastern Hill University, Shillong and Department of Anthropology, Vidyasagar University, Midnapore; 4 Department of Phar- macology, N.R.S. Medical College, Kolkata,West Bengal; 5 Department of Community Medicine, Midnapore Medical College, Paschim Medinipur, West Bengal, India Corresponding author: Samiran Bisai, MD, PhD Department of Anthropology Vidyasagar University Midnapore-721 102 West Bengal, India samiranbisai@yahoo.com Received: June 15, 2011 Accepted: March 8, 2012 SUMMARY The most common complication of herpes zoster in immunocom- petent patients is postherpetic neuralgia, which is very diicult to treat. Signii- cant beneicial efects have been found for amitriptyline, gabapentin, pregabalin, carbamazepine, sodium valproate, oxycodone, corticosteroid, topical capsaicin, tramadol, etc. The aim of this open randomized comparative study was to dem- onstrate clinical eicacy of amitriptyline and pregabalin. The study included 50 patients, 32 (64%) male and 18 (36%) female, randomized to receive either ami- triptyline or pregabalin (n=25 each). Amitriptyline was administered in a dose of 25 mg once daily and pregabalin in a dose of 75 mg twice daily. Inclusion criteria were as follows: postherpetic neuralgia of more than 1 month duration; pain of at least moderate severity; and patient age 40 years or older and no pregnancy. Patients with a history of any serious diseases (renal, cardiac, hepatic or seizure) were excluded. Total treatment period spanned 8 weeks, with patient follow up visits at 2, 4 and 8 weeks to assess the degree of improvement in pain perception and any adverse reaction. Patients with four herpes zoster types were included in this study, of which thoracic type predominated (54%). Other types were cervical in 12 (24%), trigeminal in 8 (16%) and lumbosacral in 3 (6%) patients. Prodromal symptoms before herpes zoster were reported by 66% of study patients. Satisfac- tory improvements of pain perception at the end of 8 weeks (>75%) were no- ticed in pregabalin group, which was statistically signiicant (χ 2 =10.08; P<0.05). Dry mouth was the commonest complication in amitriptyline group and dizzi- ness in pregabalin group. More importantly, none of the patients stopped treat- ment due to adverse reaction. In conclusion, therapy with pregabalin is better compared to amitriptyline in postherpetic neuralgia patients. However, a similar study in a larger sample is required to validate the present indings. KEY WORDS: amitriptyline, herpes zoster, pregabalin, postherpetic neuralgia