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Study on preventing long-term pain from shingles opens in Oxford

Volunteers with newly-diagnosed shingles are being sought for a study investigating whether a new drug can prevent long-term pain. 

The ‘Amitriptyline for the prevention of post-herpetic neuralgia’ (ATHENA) study, supported by the National Institute for Health and Care Research (NIHR), is comparing pain in those who take amitriptyline, a drug used for depression and nerve pain, with those who take a placebo ‘dummy’ drug.

About one in three people get shingles, an infection which causes a painful rash usually on the chest or tummy. The rash appears as blotches and itchy blisters on one side of the body.

The rash often heals after a few weeks but skin can be painful for months or years after the rash has gone. This is called post-herpetic neuralgia which is difficult to treat and prevent. 

Researchers at the universities of Oxford, Bristol, Southampton and Warwick are looking for volunteers aged 50 or over, recently diagnosed with shingles in Oxfordshire and respective areas to take tablets nightly for ten weeks. Half will be given amitriptyline and half placebo tablets. 

Participants will complete questionnaires about their symptoms for 12 months. Pain scores will be compared to see whether the drug helps long-term pain. 

Dr Oliver van Hecke, one of the GPs in the research team and Clinical Lecturer at University of Oxford, said: “Shingles is common and we currently don’t have any treatments that prevent the persistent pain that can last for a long time afterwards and be really troublesome. Common painkillers often don’t help and we need to seek new ways to prevent it.”

Matthew Ridd, GP and Professor of Primary Health Care at the University of Bristol, said: “A small study published in 1997 suggested that taking a low dose of amitriptyline early-on may prevent post-herpetic neuralgia.  

“However this has never been confirmed in a large trial.  We will do this in one of the largest trials of its type in the world.  If starting amitriptyline early on does help, it is a cheap medicine that would prevent prolonged, difficult-to-treat pain for thousands of people.”

For more, including a list of participating GP surgeries, visit the study website.

The study is funded by NIHR Health Technology Assessment.