Common Medication

Information provided by David D’Orazio  - Palm Springs Pharmacy

PEA
Palmitoylethanolamide (PEA) is an endopgenous fatty acid amide,that has been demonstrated in numerous clinical trials to have extensive positive biological implications relating to pain and inflammation. With time, PEA, a molecule which is normally produced in our own bodies, tones down pain to a more placid state.

Studied since 1957, PEA is found to be well tolerated with no side effects and is very helpful for neuropathic pain, headaches and arthritis.  It has both anti-inflammatory and analgesic effects, and its benefits have been shown in a number of various conditions such as:

  • Burning Mouth Pain            

  • Burning Feet                

  • Carpal Tunnel Syndrome

  • Dental pains             

  • Pelvic pains               

  • Osteoarthritis

  • Sciatic Pain                

  • Trigeminal Neuralgia           
    Neuropathic Pain (and many more)

 

PEA:

  • Is a food supplement found in eggs and milk

  • Has no significant side effects

  • Should not be used during pregnancy

  • Does NOT contain sugar, yeast, allergen, sorbitol, magnesium stearate, salicylates or other ingredients

  • It is important to note that people may notice a difference within 1 week, but in many cases it may take up to 6 to 8 weeks for the molecule to reset the system.

  • Studies comparing the effects of PEA versus Ibuprofen as pain relief in TMJ, osteoarthritis or arthralgia, have shown that pain decrease after 1 week of treatment was better with PEA than Ibuprofen. After 2 weeks of treatment, pain reduction was shown to be twice as effective as Ibuprofen.

  • PEA has been used by over a million patients, showing the potential efficacy and safety in the treatment of various syndromes with chronic pain that is poorly responsive to standard therapies. A proprietary brand of PEA has also been available in the USA, Canada, and Netherlands since 2012

Low Dose Naltrexone
Low-dose naltrexone (LDN) has been demonstrated to reduce symptom severity in conditions such as fibromyalgia, Crohn’s disease, multiple sclerosis, and complex regional pain syndrome. LDN refers to daily dosages of naltrexone that are approximately 1/10th of the typical opioid addiction treatment dosage. The clinical research to date suggests that LDN is a promising treatment approach for chronic pain conditions thought to involve inflammatory processes. It appears to increase the levels of “feel good” agents called endorphins. Some studies suggest that natural pain relievers like endorphins and other substances may be low in pain disorders like fibromyalgia and chronic fatigue syndrome (ME/CFS).

By blocking the receptors for endorphins, LDN appears to trick the brain into producing more of them. The 4-6 hours or so the drug remains in one’s system appears to be sufficient to boost the levels of endogenous opioids (those naturally found in the brain) for 18-24 hours. Given that endorphins are known as ‘natural pain relievers’ having more endorphins floating around should have a beneficial effect on pain levels.

LDN is reported to be safe, relatively inexpensive and well tolerated by most people.  That said, it is certainly still important to check its appropriateness for you with your doctor.

Lyrica (Pregabalin)
Lyrica is a prescription medication that is effective helping to control neuropathic or nerve related pain.  It is thought to control the chemicals that send pain messages to the brain via the nerves.  Whilst this drug is effective and widely used there are some side effects to be aware of.  Drowsiness, confusion, lethargy and dry mouth among other side effects can be a concern and seem to increase as the dose increases.  Lyrica may take several weeks to work and often patient need to be titrated up to an appropriate dose.   It is listed in the current Australian treatment guidelines for fibromyalgia as an appropriate to treatment.  As it is a prescription medicine, it is important to speak with your GP to assess its suitability for you.

Ketamine Infusion
Ketamine is a highly specialised pain management drug. It was invented in the 1960s for use in anaesthesia. Its use in the management of chronic pain arose when people recovering from anaesthesia who had chronic pain reported improvements in their pain, which lasted sometimes for months following the ketamine anaesthesia. Ketamine infusions involve delivering a carefully controlled dose via a small pump or via a more traditional infusion. The starting dose will be generally be very low. This is because some people (less than 1%) are very sensitive to even lower doses. A feeling of slight sedation, perhaps even some grogginess is common as the dose increases into the range where most people get some benefit.

There is some evidence that this may relieve the pain of Fibromyalgia for weeks to months at a time.  Again it is important to speak to your GP about the appropriateness of this medication for you.

Tramadol
Tramadol is a opioid style analgesic indicated to treat moderate pain.  Pain relief usually beings within 1-2 hours of taking it. It only provides a relatively small overall benefit as a fibromyalgia treatment so its use needs to be considered on a case by case basis.  Tramadol is activated in the body via metabolism but this can be quite variable in different people.  Hence, some people do not metabolise it at all, rendering it ineffective, and some metabolise it too quickly, leading to significant side effects.  Again, as it is a prescription medication, it is important to speak with your GP to assess its suitability for you.

Joncia
Joncia is a kind of medicine called a serotonin-noradrenaline reuptake inhibitor which has the ability to increase the levels of the biochemicals, serotonin and noradrenaline thereby improving the problems experienced with fibromyalgia syndrome.  It is a relatively new medication and does require a prescription from your GP.

Joncia is not used to treat depression, but it acts like medicines that are used to treat depression (antidepressants) and other psychiatric disorders. It does interact with a number of different medications and as such it is important to discuss this with your GP or pharmacists.  There are a number of possible side effects including sweating, constipation, headache and nausea.

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