Tricyclic antidepressants are generally the first choice treatment for post-herpetic neuralgia (PHN) due to their efficacy and lack of dependency. Opioids or anticonvulsants like gabapentin can also provide relief. Topical capsaicin may help but is often poorly tolerated, while intrathecal steroids can be considered for intractable cases affecting nerves other than the trigeminal nerve. Treatment aims to improve sleep, which can significantly decrease overall suffering from PHN.