ATHENA - Can taking amitriptyline tablets, stop long term pain from shingles?
About one in three people get shingles, which causes a painful rash. The ATHENA (Amitriptyline for the prevention of post-herpetic neuralgia) is a multisite trial that is recruiting patients with newly diagnosed shingles, to see whether amitriptyline can prevent long-term pain which commonly persists after the shingles rash has healed. The trial is led by Bristol's Centre for Academic Primary Care, with sites in Southampton and Oxford
Why is this important?
People with shingles should be seen by their GP as soon as possible, ideally within three days. The rash goes after a few weeks but the nerve pain can last for months or even years. This is called “post-herpetic neuralgia”, it is difficult to treat and we don’t have any means to prevent it.
Doctors and researchers at the Universities of Bristol, Oxford, Southampton and Warwick want to find out if taking a tablet called amitriptyline can prevent persistent pain. They are looking for anyone newly diagnosed with shingles in the West of England, Wessex and Oxfordshire areas.
Doctors have prescribed amitriptyline since the 1960s to treat depression. Originally it was used at high doses (75-150 mg) but nowadays it is used at low dose (10-30 mg) to treat nerve pain. In this study, the researchers are trying to find out whether low-dose amitriptyline can prevent the nerve pain caused by shingles. We are also interested to compare the cost and effectiveness of amitriptyline with other pain-relieving treatment and the use of healthcare resources.
What is involved in taking part in this study?
We need the help of 846 people with newly diagnosed shingles to join the study to enable us to answer the question, “Does taking amitriptyline when the rash of shingles first appears prevent post-herpetic neuralgia?”
Patients, who are aged 50-years or older and have been diagnosed by their GP with shingles, can take part via participating GP surgeries.
If you agree to take part:
- You will be asked to take tablets nightly for 10 weeks. (half will be given amitriptyline and the other half will get placebo (or “dummy”) tablets)
- Over the following 12 months, you will be asked to complete seven questionnaires, each 5-10 minutes long.
How long does the study last and what will happen to the results?
The study is expected to run from 2021 through to 2024. No one will be able to identify you from any of the study reports/publications.
IS THIS PROJECT FUNDED?
The study is funded by NIHR Health Technology Assessment (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).