Carbamazepine is effective in chronic neuropathic pain, with caveats. No trial was longer than four weeks, of good reporting quality, using outcomes equivalent to at least moderate clinical benefit. In these circumstances, caution is needed in interpretation, and meaningful comparison with other interventions is not possible.
Do corticosteroids prevent post-herpetic neuralgia?
Forty otherwise healthy patients over 50 years of age with early, severe painful herpes zoster were randomly allocated to two groups for treatment. Twenty patients received prednisolone 40 mg daily with gradual reduction over a period of 4 weeks, whilst the other twenty patients received carbamazepine 100 mg four times daily. Thirteen of the twenty patients (65%) in the carbamazepine treated group developed post-herpetic neuralgia lasting up to 2 years, whilst only three of the twenty prednisolone treated patients (15%) had post-herpetic neuralgia lasting up to 6 months only. Thus the incidence and duration of post-herpetic neuralgia were considerably redudced in the prednisolone treated group. In neither group did disseminated zoster or other complications occur.