Category Archives: Drugs

Center Disease Control 2016 Recommendations For Using Opioids

CDC 2016 has put out a checklist for opioid use. It does not emphasize much on  use of injection, manual medicine and other alternative techniques but does give some guidelines.

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Could Marijuana Help Headaches?

With Medical Marijuana,  migraine frequency dropped from 10.4 to 4.6 headaches per month.

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Resistant Depression – Does Folic acid Prevent Lamotrigine From Working?

Recent study added lamotrigine to depressed subjects already under treatment. Folic acid supplementation appeared to prevent any improvement versus those not on supplementation.

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Canadian Marijuana Presciption Steps

I am trying to put together a list of steps for prescribing Marijuana. This is version 1.1 – please provide additional steps. Our province dos not cover this drug even for palliative care patients (yes, we are in a bible … Continue reading

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Metformin is Mitochondrial Enhancer and Helps Bipolar Depression

A 25 yr old bipolar patient of mine was put on metformin and a weight loss program prior to hip surgery. Her mood was more stable and she noticed particularly fewer manic episodes. There is evidence in literature for metformin helping bipolar … Continue reading

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Fibromyalgia (FM) – Mitochondrial Dysfunction Helped by Metformin and Weight Loss

Adenosine Monophosphate activated Protein Kinase (AMPK) regulates cell metabolism  i.e “AMPK has a central regulatory role in cell metabolism, mitochondrial biogenesis and oxidative stress response”. Recent study of FM fibroblasts found AMPK downregulated.”AMPK down-regulation [is] at least in part responsible … Continue reading

Posted in Depression, Drugs, Fibromyalgia | 1 Comment

Pine Bark for Migraine?

Only study on Pine bark for migraine I could find used 1200 mg/day and did get impressive results on resistant migraines. But the best price I could get for that was $4/day..

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Migraine in Adolescence – Abortive Treatment -But in Canada you’ll Need a Pill Splitter

In the US, a drug combination for treatment of migraines has been released called  Treximet – sumatriptan (Imetrix) 10 mg and Aleve (Sodium Naproxen) 25  mg. It has been approved for use in adolescents 12-17. In Canada you’d have to … Continue reading

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Diabetic Neuropathy: Duloxetine Mediocre Results

For Diabetic Neuropathy – Recent study in China showed statistical significant drop of pain on Duloxetine but not clinically significant. – Have a look.

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Duloxetine For Fibromyalgia – Mixed Results

Initial study showed benefit only in first 6 weeks more than placebo and not after: Study glowingly mentions early effects but fails to mention lack of lasting effects Comment – I recently reviewed a back study that cleverly disguised their … Continue reading

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Amitriptyline – Not Much For Neuropathy Really

The initial study of use of Amitriptyline was a study with diabetic neuropathy where patients were subject to impressive coaching (calls from nurse and pharmacist) . That way doses of 75-150 mg were obtained. They were able to show benefits. … Continue reading

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Uncontrolled Post-Herpetic Neuralgia (PHN) in Elderly subject – New Measures

Using 6% gabapentin, 4% amitriptyline,  ketoprofen 10%,  lidocaine 5%, and ketamine 10% probably in Lipoderm could give some relief topically.  Ketamine 100 mg/ml with 0.1 ml spray nasally could give additional relief.  30% mannitol might be good here.

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Resistent Post Herpetic Neuralgia Treatments – IV Magnesium for Neuropathic Pains

Three IV Magnesium  1mg /k in 100 mls saline  infusions over 1 hour – one every other day or Three 1 mg/kg Ketamine in 100 mls saline infused in over 1 hour ketamine  one EOD resulted in 7/15 magnesium and … Continue reading

Posted in central & spinal, complex regional pain, Drugs, IV therapy, neuropathic, Pain Dystrophy, post herpetic neuralgia, radiculitis | 1 Comment

Complex Regional Pain Syndrome (CRPS) – Finding Immune Mechanims Offers New Treatments

Finding high levels of  beta2 adrenergic receptor autoantibodies in CRPS cases might explain why steroids, tumour necrosis factor (TNF)-alpha antagonist Adalimumab, IV Immmunoglobulins, and in present article Plasmapheresis can help in selected cases. In present study, these antibody titres fell … Continue reading

Posted in Botox, complex regional pain, Drugs, Injection, IV therapy, neuropathic, Pain Dystrophy, Stimulation | 1 Comment

Low Dose Neuropathic Pain Drugs Only Work in Combo – and then only a Bit

Neuropathic pain drugs by self have mediocre effects – often dropping pain by </= 2/10 points. At low dose Imipramine 75 mg/day and Pregabalin 300/day did not have significant benefit but the combo dropped VAS by One more than placebo … Continue reading

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Vitamin D – Could High Doses Help Pains?

4000 u/d vitamin D  lessening  Chronic Musculoskeletal Pains

Posted in Back Pain, Deficits, Drugs, Fibromyalgia, myofascial pain, pain mechanisms | 4 Comments

Neuropathic Pain 2015 and…

Mayo clinic has a review but lacks imagination

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Donepezil reduces stress induced widespread pain in mice so…

Donepezil (aricept) is used as an anticholinergic to help dementia. In the animal model repeated use can “cure” “ICS[Intermittent Cold Stress]-induced hyperalgesia [increased pain] and allodynia[touch pain] even after the cessation of drug treatments”

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Breathtaking Option for Treatment Resistant Fibromyalgia

A Water pill, Spironolactone 100-200 mg/day, can dramatically relieve pain in potentially 1/2 of Fibromyalgia cases and reduce morphine needs.

Posted in Drugs, Fibromyalgia, neuropathic | 2 Comments

Opioids Affect Immunity

Opioids can lower resistance to infections. Had on lady get couple of pneumonias which  made me reconsider which types of opioids to use in these cases.

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Pamidronate in Severe Knee Pain

Filling in my contention that pamidronate is very useful in Complex Regional Pain Syndrome, is an older article using it for CRP of the kneecap.

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Desimpramine For Neuropathic Pain a Myth

Use of  Tricyclic antidepressants (TCA)’s for neuropathic pain was based on an article for diabetic neuropathy where, through frequent phoning and support, authors were able to get patients up to 150 mg. No one has succeeded in getting people up … Continue reading

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Acetaminophen (paracetamol) does not work in acute Back Pain

Double blind study found Paracetamol (acetaminophen) at average dose of 3500 mg/day in week 1 and 2800 mg/day in week 2 for the regular group was not better than placebo.  It had `no eff ect on pain, disability, function, global … Continue reading

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Case of Wrist Complex Regional Pain (CRPS) Helped by Dextroamphetamine

While dealing with infertility with dextramphetamine, patient’s wrist CRPS pains issues subsided

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Methotrexate for Knee Osteoarthritis

On methotrexate up to 25 mg/week orally, 53% had over a VAS drop of  2.0/10 while only 24% had in control group.

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