By Lorelei Hunt, Patient and Public Involvement Representative on the ATHENA Shingles Study, Centre for Academic Primary Care, University of Bristol
Doctors involved in the ATHENA shingles trial were interviewed by the Daily Mail, under the headline ‘Could taking a depression pill prevent lasting agony of shingles? Scientists launch clinical trial to examine effectiveness of treating post-herpetic neuralgia with amitriptyline‘.
We need to recruit more people to take part in this important pain prevention study, so raising awareness is a good thing. But some comments made on the newspaper’s website about the medication (amitriptyline) were unhelpful or wrong.
As the patient representative on the research team, I agreed to read through all of them. There were a lot, so this took a while! Unfortunately, many people did not read past the headline and recalled their own past, sometimes unpleasant experiences of having taken amitriptyline in very different circumstances. (For context, 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.)
There were also lots of comments about the very positive impact of taking amitriptyline for the treatment of pain. This is very helpful but still isn’t what the trial is about – which is whether taking amitriptyline early on can prevent the painful, long term nerve pain that can result from shingles, called post-herpetic neuralgia (PHN).
I was very pleased to see quite a few comments by careful readers who took the trouble to explain how the trial was different from past uses of amitriptyline. I hope this might balance out any misunderstanding arising from people’s comments on their own experiences.
So, overall I think this publicity was good publicity and I hope it will help to encourage people to be interested in, and participate in, the ATHENA trial.
For the record, here are some key facts:
- The ATHENA shingles trial is about the use of a drug called amitriptyline to prevent PHN from occurring, not to treat existing pain.
- The immediate pain from the blistering shingles rash is different to the longer-term nerve pain that can result from shingles. You can still take/ask for pain relief during the trial.
- The dose of amitriptyline used for the trial is much lower than the dose used in the past to treat depression.
- Patients entering the trial are carefully screened to make sure they do not have other illnesses or take medication that should not be taken with amitriptyline.
- You can take part in the trial if you are registered at one of 238 GP surgeries in England.
- The trial is funded by the National Institute for Health and Care Research (NIHR), which is the research arm of the NHS and is independent of any drug companies.
You can follow the study’s progress via the study website and Twitter account.
The ATHENA shingles trial is led by Professor Matthew Ridd, a GP and Professor of Primary Health Care at the Centre for Academic Primary Care, University of Bristol.