DRUG THERAPIES

- DRUG THERAPIES ARE NOT A CURE BUT THEY CAN OPTIMIZE PAIN CONTROL AND PROVIDE THE RELIEF NECESSARY TO REGAIN FUNCTION AND ALLOW THE PATIENT TO PARTICIPATE IN PHYSICAL THERAPY.

FOR CHRONIC PAIN PATIENTS, DRUG THERAPIES ALLOW PATIENTS TO REGAIN A BALANCE IN THEIR LIVES AND RESUME MANY ACTIVITIES THEY HAD PREVIOUSLY STOPPED. HERE WE WILL SIMPLY GIVE THE BASIC MEDICATION TYPES, AN EXAMPLE, AND WHAT THEY ARE FOR.

ANALGESICS:

- OPIATE AGONISTS – THESE MEDICATIONS TRY AND REDUCE CENTRAL NERVOUS SYSTEM ACTIVITY AND THEREBY REDUCE PAIN. OPIATE AGONISTS ACT ON OPIOD RECEPTORS TO INITIATE ANALGESIA, SEDATION, AND EUPHORIA. COMMONLY USED OPIATE AGONISTS ARE MS CONTIN, MORPHINE, OXYCONTIN, OPANA, & HYDROCODONE.

- OPIATE ANTAGONISTS - OPIATE ANTAGONISTS BLOCK AND REVERSE THE EFFECTS OF OPIOID AGONISTS BY COMPETITIVELY ADHERING TO OPIOID RECEPTORS. AN EXAMPLE OF AN OPIATE ANTAGONIST IS NALTREXONE.

NARCOTICS – USED TO MASK PAIN BY BLOCKING PAIN RECEPTORS FROM SENDING PAIN MESSAGES TO THE BRAIN. NARCOTICS ARE ALSO KNOWN AS OPIOIDS. THESE ARE BROKEN DOWN INTO THREE TYPES; CODEINE-BASED MEDICATIONS, THE OXYCODONE BRANCH (OXYCONTIN CR and IR, PERCOCET, PERCODAN, for example), AND THE HYDROCODONE BRANCH OF OPIODS (MS CONTIN, VICODIN, LORTAB, LORCET, METHADONE, AND KADIAN, for example).

Most Drs will prescribe the ER (extended release) or CR (controlled release) versions of these narcotics for a more evenly distributed release of medicine during the day.

So what is the difference then between the OXYCODONE Branch and the HYDROCODONE Branch If you search the Internet here is what most of the double-blind studies show: OXYCODONE and HYDROCODONE are similar in analgesic effect, but OXYCODONE is generally as effective at 66% of the dosage of HYDROCODONE. Individual medications may vary and each patient will vary slightly as well but it gives you an overall idea.

ALSO INCLUDED IN THE NARCOTICS FAMILY IS FENTANYL, EITHER IN THE MORE COMMON PATCH OR THE LESS COMMON LOLLIPOP FORM, ACTIQ. (for more information on what the FENTANYL PATCH is click on the link FENTANYL PATCH INFORMATION

ANTIDEPRESSANTS – ORIGINALLY ONLY USED TO TREAT DEPRESSION, STUDIES HAVE SHOWN THAT THESE MEDICATIONS, BOTH THE NEWER ANTIDEPRESSANTS AND THE OLDER TRICYCLIC VERSIONS, CAN ALLEVIATE PAIN IN CERTAIN SITUATIONS. FURTHERMORE, THEY MAY HAVE THE ADDED BENEFITS OF NOT ONLY HELPING THE PATIENT SLEEP BETTER AT NIGHT BUT ALSO REDUCING SOME OF THE HEADACHES ASSOCIATED WITH RSD/CRPS; ALTHOUGH SOME HAVE A TENDENCY TO CAUSE WEIGHT GAIN AND DROWSINESS. PAXIL, ZOLOFT, ELAVIL, PAMELOR, AND TRAZADONE ARE GOOD EXAMPLES.

TEENS NEED TO BE CAREFUL ON THE DOSING AS SOME STUDIES HAVE LINKED THE USE OF ANTIDEPRESSANTS TO INCREASED SUICIDE RATES. ALWAYS TALK THESE ISSUES OVER WITH YOUR PHYSICIAN.

WORRIED ABOUT ADDICTION WITH OPIATES? IS THERE A DIFFERENCE BETWEEN ADDICTION AND TOLERANCE?

For more information go to ADDICTION AND OPIODS

ANTICONVULSANTS – THESE MEDICATIONS ARE USED TO TRY AND DECREASE THE RANDOM NEURONS FIRING, THEREBY DECREASING THE BURNING PAIN AND SENSITIVITY ASSOCIATED WITH RSD/CRPS. THIS CAN SOMETIMES ALSO DECREASE THE PAIN. EXAMPLES INCLUDE; TEGRETOL, TOPOMAX, AND NEURONTIN. RECENTLY LYRICA HAS ALSO BEEN USED BY SOME DOCTORS IN THIS REGARD.

ANTISPASMODICS / MUSCLE RELAXANTS – MUSCLE SPASMS ARE VERY COMMON WITH RSD, TYPICALLY ROLLING IN NATURE. THE MEDICATIONS USED TO TREAT THIS CAN INCLUDE BACLOFEN, CLONAZEPAM, FLEXERIL, SOMA, AND ZANAFLEX. SOMETIMES A DOCTOR MAY PRESCRIBE A BENZODIAZEPINE FOR THIS. THESE CAN INCLUDE KLONOPIN, VALIUM, AND XANAX. ANTISPASMODICS SUCH AS NEURONTIN CAN BE PRESCRIBED FOR SPASMS BUT THIS IS NOT CONSIDERED A PAIN-RELIEVING DRUG ANYMORE, NOT SINCE THE LATEST REPORTS WERE RELEASED (see other articles on this website for more information).

NSAIDS – USED TO TREAT SWELLING AND INFLAMMATION. THESE CAN INCLUDE CELEBREX AND FELDENE. THEY FORMERLY INCLUDED VIOXX AND BEXTRA BUT THEY HAVE BEEN TAKEN OFF OF THE MARKET. ACCORDING TO DOCTOR TIM SAMS, “MOST RESEARCH HAS DEMONSTRATED THE EFFICACY OF THE COX-2 INHIBITORS, (CELEBREX/FELDENE) BUT HAS CLEARLY NOT FOUND THEM TO BE BETTER PAIN RELIEVERS THAN THE OLDER OR EVEN NONPRESCRIPTION NSAIDS”.

NMDA RECEPTOR BLOCKERS - THIS WOULD INCLUDE THE DRUG KETAMINE. I WOULD REFER YOU TO THE FOLLOWING SECTION FOR INFORMATION, ARTICLES, AND STUDIES REGARDING THE USE OF KETAMINE IN THE TREATMENT OF RSD / CRPS;

KETAMINE AND RSD AND/OR LOOK FOR THE BIG BLUE BUTTONS REGARDING KETAMINE ON THE MAIN PAGE OF THE WEBSITE.

TRANSDERMAL MEDICATIONS – PAIN PATCHES, LIDOCAINE AND DURAGESIC/FENTANYL. MOST IMPORTANT WITH THESE ARE THEIR PLACEMENT. CHECK WITH YOUR PHYSICIAN, BUT TYPICALLY THEY ARE NOT PLACED DIRECTLY OVER THE RSD-AFFECTED AREA.

TO READ ABOUT THE SCHEDULES OR CLASSES OF PRESCRIPTION DRUGS SEE THE LINK BELOW;

SCHEDULES OR CLASSES OF DRUGS

For additional articles regarding Pharmacological Treatment of RSD / CRPS, see;

PHARMACOLOGIC THERAPIES FOR CRPS