DEAR DR. ROACH: A friend’s daughter had shingles when she was in her late 30s. Three years later, she still suffers from postherpetic neuralgia (PHN). She has tried gabapentin and many other treatments with poor results. Are you aware of any new treatments or clinical trials for PHN, especially in someone so young? -- D.M.

ANSWER: I am sorry for your friend’s daughter. PHN is among the most exquisitely painful conditions known. It is quite unusual in a person so young.

The initial treatment for PHN is usually a medicine like gabapentin. In the study that got the drug approved for this purpose, the goal dosage was extremely high -- about 1,200 mg three times daily, which takes weeks or months to build up to. Still, it is sometimes not tolerated by many patients, and I often see people “fa

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