At this point, twice daily applications of topical 2% amitriptyline compounded with 0.5% ketamine in an organogel were added to the patient’s treatment regimen. The gel was initially applied only to the skin surrounding the affected area, but as the erosions healed the gel was applied to the area of herpetic infection.
Within four days of the initial treatment with the compound gel, the patient’s pruritus had decreased from 7/10 to 5/10. Pain levels were similarly affected. According to the study, the patient reported that treatment with topical 2% amitriptyline / 0.5% ketamine gel gave him significant relief.
“The response of this patient's pain to the topical formulation of amitriptyline and ketamine suggests that this topical combination could be used for the skin pain associated with herpes simplex,” Dr. Davis tells Dermatology Times. “This formulation may decrease the necessity for systemic opioids for control of pain.”
The study appears in the February issue of Journal of Drugs in Dermatology.