Evaluating the efficacy of combination therapy of Pregabalin plus Nortriptyline in the management of PHN patients: A randomized controlled study

Background: Post Herpetic Neuralgia (PHN) is chronic neuropathic pain. It is a complication of herpes zoster and negatively impacts the patient’s quality of life and physical, occupational, social and psychosocial abilities due to unceasing pain. As pain management remains the cornerstone in treating such patients, this study was undertaken to determine the efficacy of fixed-dose combination therapy of Pregabalin plus Nortriptyline in PHN. Methods: The study, which was a follow-up, randomised, single-blind, controlled study, included a total of 40 patients who had chronic pain for at least 12 weeks with a Numeric rating scale (NRS) score of 5/10 or above. Group A (n=20) received pregabalin 75 mg plus nortriptyline 10 mg, and group B (n=20) received pregabalin 75 mg for a total of 12 weeks. Pain intensity and severity (using NRS and Global Perceived Effect), pain interference with sleep (using Numeric Rating Scale-Sleep (NRS-Sleep) and Pain Detect Questionnaire (PDQ)), pain quality (using Neuropathic Pain Symptom Inventory (NPSI)), and quality of life (QoL) (using Short Form-12 (SF-12) questionnaire) at the end of the first, second, fourth, eighth and twelfth week were measured. Results: Significant (p <0.05) decline in Numeric rating scale (NRS) scores, NRS sleep and NPSI scores in group A along with significant (p <0.05) improvement in PDQ, GPE and QoL scores, when compared to group B. Conclusion: The combination of pregabalin plus nortriptyline therapy has better patient outcomes in PHN as compared to pregabalin monotherapy.