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Postherpetic neuralgia (PHN) is defined as pain persisting for >3 months after acute herpes zoster (“shingles”).1,2⇓ Tricyclic antidepressants, opioids, gabapentin, and the lidocaine patch have been proven effective, but many patients fail to achieve relief.2 Levetiracetam (Keppra; UCB Pharma, Lake Smyrna, GA), approved in the USA as adjunctive therapy for partial-onset seizures, has an incompletely characterized mechanism of action that includes inhibition of N-type calcium channels and modulation of γ-aminobutyrate and glycine receptors.3-5⇓⇓ Levetiracetam is active in animal models of neuropathic pain.6 There are no case reports or prospective studies of levetiracetam for chronic neuropathic pain.
Methods.
Ten subjects in stable health without significant pain besides PHN were recruited for this prospective open-label tolerability and effectiveness study of levetiracetam, approved by the University of California San Francisco Committee on Human Research. A 1-week baseline period was followed by a 12-week treatment period. Subjects were seen a total of six times.
Diary measures consisted of daily diary pain rating (0 to 10 Likert scale) of average pain …
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