Amitriptyline/Ketamine as therapy for neuropathic pruritus and pain secondary to herpes zoster

J Drugs Dermatol. 2015 Feb;14(2):115-8.


Frequent causes of morbidity secondary to herpes zoster include acute pain, secondary infection, and postherpetic neuralgia. A less documented complication is pruritus, which can be either acute or postinfectious when it persists more than 3 months after the rash has healed. We discuss a case of severe, acute neuropathic pruritus and pain secondary to active herpes zoster that was unresponsive to standard medical therapy, including oral antihistamines, topical lidocaine, oral gabapentin, and local wound care. Modest control of the pruritus and pain was achieved with continued multimodal therapy and the addition of topical 2% amitriptyline/0.5% ketamine gel.

Publication types

  • Case Reports

MeSH terms

  • Administration, Cutaneous
  • Amitriptyline / administration & dosage
  • Amitriptyline / therapeutic use*
  • Analgesics / administration & dosage
  • Analgesics / therapeutic use
  • Drug Combinations
  • Gels
  • Herpes Zoster / complications
  • Humans
  • Ketamine / administration & dosage
  • Ketamine / therapeutic use*
  • Male
  • Middle Aged
  • Neuralgia, Postherpetic / drug therapy*
  • Pruritus / drug therapy*
  • Pruritus / virology


  • Analgesics
  • Drug Combinations
  • Gels
  • Amitriptyline
  • Ketamine