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Page: Prevention
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Primary prevention
In 1995, the Food and Drug Administration (FDA) approved the vaccine to prevent chickenpox. Its effect on PHN is still unknown. The vaccine — made from a weakened form of the varicella-zoster virus — may keep chickenpox from occurring in nonimmune children and adults, or at least lessen the risk of the chickenpox virus lying dormant in the body and reactivating later as shingles. If shingles could be prevented, postherpetic neuralgia could be completely avoided.
Recently, Merck has tested a new vaccine (Zostavax) against shingles (PMID 15930418). This vaccine is a more potent version of the chickenpox vaccine. Evidence indicates that the vaccine reduced the incidence of shingles by 51 percent. Additionally, the vaccine reduced the incidence of PHN by two-thirds compared to placebo. However, the vaccine's protective effects diminished over the three years that most patients were followed In December 2005, an FDA advisory committee unanimously agreed that the vaccine is safe and effective for persons over 60 years old. This was followed on 2006-05-26 by the FDA formerly approving the use of the vaccine for that same age group. Further studies may demonstrate if there is benefit in patients 50-59 years old and if a booster dose is recommended.
Secondary prevention
* A meta-analysis reported that treating zoster at the time of rash with antiviral agents such as acyclovir can reduce the chance of postherpetic neuralgia.
* A randomized controlled trial found that amitryptyline 25 mg per night for 90 days starting with two days of onset of rash can reduce the inicidence of postherpetic neuralgia from 35% to 16% (number needed to treat is.
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Important notice:
The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other
qualified health provider with any questions you may have regarding a medical condition.
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