THE TREATMENT OF TRAMADOL WITH CREAM CONTAINING 3.33% DOXEPIN AND 0.05% CAPSAICIN ON THE OVERALL IMPROVEMENT OF QUALITY OF LIFE IN POST HERPETIC NEURALGIA PATIENTS

The main purpose of the study was to examine the effect of QoL of PHN patients after the treatment of tramadol (50mg-200mg), with topical cream containing 3.33% doxepin and 0.05% capsaicin and clinical correlations with CYP2D6 polymorphism. The study was prospective, non-responders versus responders, conducted in 246 outpatients of PHN undergoing tramadol treatment for 4 weeks. Rescue analgesia given in the form of the topical cream consisting of the combination of 3.33% doxepin and 0.05% capsaicin to the affected areas of patients along with tramadol therapy. The QoL as per WHO QoL BREF Questionnaire was evaluated in all the study participants. All samples were analyzed for CYP2D6 (*2,*4 and *10) polymorphism using PCR-RFLP method. Although the QoL score showed magnitude of improvement was higher in responders as compared to non-responders. Insignificant interactions were found in all domains of QoL with respect to CYP2D6*2 and CYP2D6*4 polymorphism. However, a significant (p<0.001) interaction was found in CYP2D6*10 polymorphism with respect to environmental domain of QoL. A significant interaction was found with CYP2D6*10 allele with respect to environmental domain of QoL whereas lack of an association was found between CYP2D6*2 and *4 polymorphisms with QoL in PHN patients.