Here's some info I lifted from the Herpesite. I hope it helps! I'll post it for another
person checking into "numbness", too.
Post Herpetic Neuralgia
Neuralgia is pain that occurs along the path of the nerves. This condition is best
known in relation to Shingles(Varicella Zoster Virus).
Although it has been little studied in connection with genital Herpes Simplex infection,
the incidence of this condition is much more common that is normally reported.
This type of neuralgia is the result of the virus irritating the nerves and neural
pathways. The symptoms are similar to Prodrome,including tingling,twitching, burning
sensations, shooting pains, numbness, and/or aches in the area of infection, and also
particularly in the buttocks,
legs, and thighs.
The pain can be intermittent, and in some people it can be chronic, lasting for weeks
and months at a time. This kind of chronic HSV-PHN is considered to be rare, although
anecdotal evidence suggests that it occurs much more frequently than has been
documented. HSV can also cause a "sciatica syndrome" - pain the sciatic nerve in
the back of
the thigh. Many women have found their PHN intensifies prior to menstruation.
When PHN is accompanied by frequent outbreaks, some people have found a course of
suppressive anti-viral drug therapy to be helpful. There is conflicting advice on the
effectiveness of suppressive therapy with acyclovir (Zovirax). Some research indicates
that it either has no effect, or that it worsens "unexplained nonlesional HSV
episodes." Some people do find that daily suppressive therapy with acyclovir brings
them relief from PHN, possibly by decreasing the irritation to the nerves caused by
Acyclovir works by interrupting the new viral replication, and by keeping the virus in
check, the nerves are able to calm down and rest after having been irritated for so long.
This may take weeks or even months to achieve, depending on various factors, and it's
effectiveness appears to increase dramatically by being very regular in the timing of the
Elavil, as well as certain other tricyclic antidepressant medications, have pain
reduction properties that appear to be independent of their antidepressant actions, and
have been recommended and used for PHN associated with Shingles. The pain alleviation
effect can be reached at doses much smaller than those normally required for the
Several medical reference books mention these drugs for "post-herpetic
neuralgia" specifically. The drugs mentioned as being possibly effective in relieving
neurogenic pain are: imipramine(Tofranil), nortriptyline (Aventyl), amitriptyline
(Elavil),clomipramine, desipramine, doxepin, and trimipramine. Especially the first three.
However, there are many possible side effects to consider when investigating the use of
these drugs. Also, if a person is already taking another type of anti-depressant or any
other drug, they may have to go off it for quite a while before starting a new one, or
they could have serious complications. As always, discuss every aspect of possible
treatments and their side effects with your health care provider.
Another treatment that has been shown to be very effective in many cases of neuralgic
pain are topical creams containing Capsaicin.
Capsaicin is derived from chile peppers, and works by inhibiting accumulation of
"substance P," which sends pain signals from the nerves to the brain. Studies
have been done with shingles PHN that have shown Capsaicin's effectiveness. Some people
here at HerpeSite prefer "Arthricare Extra Strength Pain Relieving Rub, Odor
Free." Another brand that was designed originally and specifially for shingles PHN is
"Zostrix"(named after Varicella Zoster Virus, the herpesvirus that
causes chicken pox and shingles!), but Arthricare is much less expensive, and also
contains methyl nicotinate (a form of niacin) which dilates the blood vessels under the
surface of the skin. The main things to remember if choosing to use one of these creams
are: 1) Wash hands immediately after applying, 2) Rub it in gently or it will burn worse
than an outbreak, 3)never put it on mucous membranes, 4) heat and warm water will
intensify the effects (so no sunbathing, showering, or hot baths afterward!), and 5)
Capsaicin's benefits are cumulative, so it may take up to several weeks to achieve full
Some people have found that eliminating coffee and other neuro-stimulants has helped in
both dereasing PHN and outbreaks. There are also some medical experts who say that the
neuralgia, like many other aspects of herpesvirus infections, gets better by itself with
Experts advise that patients experiencing prodromal symptoms or PHN consider the virus
to be active, and to take precautions against transmission.
....BTW imipramine is a nasty drug - we used to use it on the kids at he hospital -
however cardiac side effects were noted often - these were potenially life threatening...
Zoloft is a great anti-depressant and would be a good choice as Meg has said - low AE
profile - easy to regulate dosage for the neuralgia