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New study to investigate if amitriptyline can prevent shingles pain

Image by Mariegriffiths from Wikimedia -

6 September 2021

A new study called ATHENA will find out if a medicine called amitriptyline can prevent pain after shingles.

Researchers at the Universities of Bristol, Oxford and Southampton have been given £1.8m by the National Institute for Health Research to investigate whether taking low-dose amitriptyline can prevent the long-term pain that some people get after shingles.

Shingles, also known as herpes zoster, is caused by the same virus that causes chickenpox. It appears as a rash on one side of the body, which can be painful for weeks after the rash has gone.

While antiviral medicine helps reduce initial pain and rash severity, no treatments prevent long-term pain (“post-herpetic neuralgia”).

Amitriptyline used to be prescribed at high doses to treat depression but is now used at low dose for nerve pain. A previous small study suggested that taking a low dose of amitriptyline early on may help prevent post-herpetic neuralgia.

Matthew Ridd, Professor of Primary Health Care at the University of Bristol's Centre for Academic Primary Care, said: "“I’m delighted to be working on this study with a multidisciplinary team of GP researchers, pain specialists and research experts to answer the question of whether amitriptyline can be used to prevent the disabling pain after shingles.”

The researchers, all members of the NIHR School for Primary Care Research, will recruit 846 adults into a clinical trial to find out if using amitriptyline when the shingles rash first appears really prevents pain later on.

Participant recruitment will start in January 2022. Patients presenting to GP surgeries in the West of England, Wessex and Thames Valley areas will be invited to take part. The findings are expected in late 2024.

For more information, email, visit our website or follow @AthenaStudy on Twitter.

The research is funded by the National Institute of Research (NIHR) Health Technology Assessment programme (NIHR129720). The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health and Social Care (DHCS).

Further information

About the Centre for Academic Primary Care, University of Bristol
The Centre for Academic Primary Care (CAPC) at the University of Bristol is a leading centre for primary care research in the UK, one of nine forming the NIHR School for Primary Care Research. It sits within Bristol Medical School, an internationally recognised centre of excellence for population health research and teaching. Follow us on Twitter: @capcbristol.

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