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- Chronic “Back” Pain Missed in Elderly – the Costo-Iliac Impingment Syndrome on
- Lateral to Upper Eyelid Lacrimal Neuralgia on
- Pramipexole Stops MS in Animal Model – Helps Restless Legs, Fibromyalgia, and May Help Resistant Depression on
- Severe Neuropathic Pain – Only 1/4 Respond to Standard Drug Protocols – What Else Is There? on
- Office Ketamine For Chronic Pain Poster on
Category Archives: Drugs
I have published on the use of ketamine to treat pain/depression/suicidality. Now a weak painkiller / partial painkiller blocker has been shown to help depression, not with one study, but with findings from twelve studies.
Opioid deaths seem to be fueling more by Chinese derived illicit fentanyl. However, massive efforts are made to lower opioid dose. One study was successful at getting opioid consumption down from 288 mg to 150 mg. They weren’t any better … Continue reading
It has been said Opioids and tranquilizers can increase risk of overdose death five fold. In my population, there is a subgroup of cases with bipolar disorder. Indeed, a meta-anlysis found 21 – 25% of Fibromyalgia disorder have it and … Continue reading
NSAID/arthritis pills have painkilling action centrally and this now appears to be related to its effect on opioid system. Unfortunately it means you can develop tolerance either because you are on an opioid or because its effects on descending inhibitory … Continue reading
I have used frequent B12 shots as an analgesic for resistant pain cases. For men over 40, 10 yr. use of injectable B12 is linked to doubling lung cancer risk.
Imipramine drops polyneuropathy pain by one and has no increasing effect with dosage suggesting most effect is placebo. Pregabalin drops pain by 0.4 and marginal/not significant drug dosing effects suggesting neither is much use alone.
In rat model, vitamin C prevents oxidative stress on liver and kidney
Both duloxetine and pregabalin work by restoring brain down pain inhibition. Hence the work in people who have deficits in this system. There is a simple test to confirm functioning.
“Severe high altitude headache occurred in 3% treated with ibuprofen and 10% with placebo”
“Sedative-hypnotic use compared with nonuse was associated with 6.4 times the risk of opioid overdose death. … Even at opioid doses 1-19 mg/d, patients using sedative-hypnotics concurrently had 5.6 times the risk than patients without sedative-hypnotics”. I must admit I have … Continue reading
Venlafaxine (300 mg/d) and Clonazepam (5 mg/d) in Refractory Burning mouth – All responded with a reduction in pain from 8.6/10 to 3.2/10 after 3 months
New approaches include topical neuromodulation which means “Podophyllotoxin (5 mg/mL) applied locally to tender points of vestibule after 5% acetic acid application. Treated area was covered with a mild estrogen cream and covered with gauze pads until the next day” … Continue reading
Traditionally, an old antidepressant, amitriptyline, has been used for irritable bowel at doses far lower than its antidepressant level, as an aid to stimulating endophin system etc. Now it appears that more up to date SSRI’s work better. This was … Continue reading
here is poster in pdf format: Poster CPS 2017 ketaminefinal (2)
I contend antidepressants help very little in back pain and waiting for it to work before starting painkillers is an unethical abomination. Studies showing any benefit in the last century are laughable because dosages used would not be achievable today. … Continue reading
Two approaches to gallbladder advanced testing – use of fatty meal (FM) as a substitute for cholecystokinin (CCK) in pain reproduction during hepato-imino-diacetic acid (HIDA) scan in functional gallbladder disorder. – will miss 1/2 of cases
Previously I wrote how metformin helps Fibromyalgia and Bipolar. It has anti-cancer properties and diabetics, just on it, live longer. Now in animal model it it cut analgesic needs by 56-73% in regard to ibuprofen, ASA, tramadol, and pregabalin in … Continue reading
Operative case serotonin syndrome induced by Merperidine caused “hypertension, tachycardia, tachypnea, hyperthermia, myoclonus, diaphoresis, retching, nausea, agitation, and semicoma mentality with no pupillary light reflex.” Incidentally, patient was given famotidine, in this case IV, to prevent aspiration pneumonia. Within 15 … Continue reading
In rodents, Melatonin helps prevent peripheral nerve damage from Oxaliplatin for colon cancer without reducing its cyotoxic effects on cancer. Doses were large, but I would give it a try..
I have an MS patient who was in bad shape when I started to see her – was using a walker. With various measures, she was much better. What worked? Vit D2 50,000 u weekly, B12 injections 1000 mcg … Continue reading
Topical anti-inflammatory drug would be the safest way to go in knee arthritis for example. Yet the number of patients needed to treat to help one case was Ketoprofen – one in 6.9 cases Diclofenac (Voltaren) – one in 9.8 … Continue reading
Recent study paradoxically found elevated B6 levels – up to 4 times normal in 1/6 of burning mouth cases and stopping B6 seemed to help in a case. Could this be of help in others?
Came across a wonderful list of drugs available for post-dural headaches: https://www.asra.com/content/documents/aug-14.pdf p13-14,23 If you can’t reach it, here is the list and more
Had one case where I treated unrelenting headache with repeated IV Dihydroergotamine and metoclopramide just to find, as patient settled, that headache originated from a painful patch on the scalp called nummular headache. This is often due to a crushed nerve … Continue reading
Spanish journal which I do not get but results seem clear enough – ketoralac 60 mg ?IM and Nifedipine XL 30 mg by mouth give best results.