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Category Archives: Drugs
Topical NSAID Ketophen or Diclofenac – Poor Showing
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
Posted in Drugs, Knee, Topical Pain Treatments
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Burning Mouth Syndrome – Could a Subgroup With Elevated B6 Levels be Helped by Stopping B6?
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?
Posted in Drugs, ENT
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Pramipexole Stops MS in Animal Model – Helps Restless Legs, Fibromyalgia, and May Help Resistant Depression
In the mouse model of Multiple Sclerosis, Pramipexole, a antiparkinson drug, stops the brain neuroinflammation and that form of MS called “Experimental Autoimmune Encephalomyelitis”. This agent is used extensively for restless legs – Got MS and restless legs? – I … Continue reading
Posted in central & spinal, Drugs, Leg Pains, Uncategorized
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Post Dural Headache Treatments
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
Posted in Drugs, Headaches, Injection
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New Treatment for Uncontrollable headaches New RX for Nummular Headache Underlying
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
Kidney Stone – Renal Colic – Ketoralac and Nifedipine Superior to Ketoralac and Tamsulosin
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.
New Effective Treatment for Intractable Sore Mouth Mucositis
0.05% Methylene Blue oral rinse therapy was cheap and effective treatment for mucositis from chemotherapy or radiotherapy. Amazing result could be big help.
Posted in Abdominal pain, Drugs, ENT, Injection, neuropathic, skin
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Reasons Why Vit D Helps Chronic Pain Coming Clearer – Vit D Genes
A Fokl DNA gene polymorphism in the Vitamin D receptor would reduce its sensitivity to vitamin D. Vitamin D supports many metabolic processes beyond calcium and gene variations are even associated with certain cancers. In athletes, the FF Fokl genotype … Continue reading
Posted in Back Pain, Drugs, Fibromyalgia, pain mechanisms, Uncategorized
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Dry Eyes More Common In Certain Chronic Pains and Made Worse by Low Vitamin D – Replacement Helps
Prior I wrote about a Dry Eye- Mouth Syndrome (DEMS) that has some joint involvement. DEMS is associated with thyoid antibodies suggesting an autoimmune process (1). Now It was found more commonly in irritable bowel, chronic pelvic pain and irritable … Continue reading
Posted in Drugs, eyes, Fibromyalgia
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Shooting Trigeminal Neuralgia – Facial Epicrania Fugax – and a New Treatment
6-8 years ago a brief neuralgic pain in the scalp that radiated to front or back of head was described. I wrote about it here: http://painmuse.org/?p=1516 Now a facially originated version has been defined and sounds very much like trigeminal … Continue reading
Posted in Drugs, neuropathic, Trigeminal Neuralgia, Uncategorized
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Gabapentin Fails to Help Back Pain With or Without Sciatica
Not all that long ago, Canadian Indian Affairs mandated that native pain sufferers had to try gabapentin/cymbalta like drugs first before certain opioids. I wrote about how poorly cymbalta worked: http://painmuse.org/?p=2179 Now even gabapentin failed to help back pain with … Continue reading
Does Etanercept Nerve Irritation Limit Use?
Many years ago I was injecting enbrel paraspinously near the nerve exit of sciatica nerve location. I was using a full 25 mg and found it had minimal effects. I wrote E. Tobinick at times and wondered if it was … Continue reading
Posted in Back Pain, Drugs
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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.
Posted in Drugs
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Could Marijuana Help Headaches?
With Medical Marijuana, migraine frequency dropped from 10.4 to 4.6 headaches per month.
Posted in Drugs, Headaches, Uncategorized
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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.
Posted in Depression, Drugs
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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
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
Posted in Depression, Drugs
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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
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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..
Posted in Drugs, Headaches
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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
Posted in Drugs, Headaches
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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.
Posted in Drugs, neuropathic
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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
Posted in Drugs, Fibromyalgia
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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
Posted in Drugs, neuropathic
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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.
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