Alternatives to Opioids in the Pharmacologic Management of Chronic Pain Syndromes: A Narrative Review of Randomized, Controlled, and Blinded Clinical Trials – free full-text /PMC5785237/ – 2018 Nov
This recent review finds that there is very little evidence beyond a few weeks for the “effectiveness” [see qualification at end of review] of any non-opioid medication that has some beneficial effect on pain.
The goal of this review was to report the current body of evidence-based medicine gained from
- blinded studies
on the use of non-opioid analgesics for the most common non-cancer chronic pain conditions. Continue reading
Fast-Acting Depression Drug, Newly Approved, Could Help Millions – By Benedict Carey – Mar 2019
This is wonderful news because it’s from a different drug class than what’s been available.
This new approach brings fresh hope for those of us who have been hanging on, gritting our teeth, and tolerating our treatment-resistant depression because we can’t get sufficient relief from the current medications.
A nasal spray version of the drug ketamine has shown promise as an antidepressant, even if its properties still aren’t well understood. Continue reading
Guidelines, Editors, Pharma And The Biological Paradigm Shift – free full-text /PMC3192391/ – Dec 2007
Private investment in biomedical research has increased over the last few decades. At most places it has been welcomed as the next best thing to technology itself.
Much of the intellectual talent from academic institutions is getting absorbed in lucrative positions in industry.
Applied research finds willing collaborators in venture capital funded industry, so a symbiotic growth is ensured for both.
Already in 2007, money was exerting a powerful influence. By now, it’s becoming clear that financial interests are shaping (and often corrupting) the proper practice of medicine. Continue reading
Fluoroquinolones Overprescribed Despite Dangers – Matt McMillen – Feb 2019
This is the strongest warning I’ve seen about these common antibiotics and it makes me wonder why they don’t mention it to us when the drugs are prescribed.
In 2006, Rachel Brummert developed a sinus infection, and her doctor prescribed Levaquin, one of a class of powerful antibiotics called fluoroquinolones.
Shortly after she began taking the drug, she went on an errand. While crossing a parking lot, her Achilles tendon ruptured. Her foot went limp. The agony felt unbearable. Continue reading
Medicare Patients Face New Rx Opioid Rules in 2019 — Pain News Network – December 31, 2018/ Pat Anson
The Centers for Medicare and Medicaid Services (CMS) will implement new safety rules on January 1 that could make it harder for over a million Medicare beneficiaries to get prescriptions filled for high doses of opioid pain medication.
Prescriptions for opioid “naïve” patients – those who are new to opioids — will also be limited to an initial 7-day supply, regardless of dose.
The new rules, which are modeled after the 2016 CDC opioid guideline, are intended to reduce the risk of opioid abuse and addiction.
Of course, they accomplish neither in real life. Continue reading
Pain Processing: Examining the Role of Oxytocin – Rodriguez, MA, LPC – Nov 2017
This is a brief, but technical article about how oxytocin might be useful for chronic pain. While it doesn’t do anything for nociception, it seems to alter the sensation of pain by reducing the part that makes it “hurt like…” not just “feel like…”.
The role of oxytocin (OT) in pain perception has been extensively studied, mainly in animal models; however, a limited number of studies have examined the analgesic effects of OT in humans.
A review recently published in Neuroscience explores the evidence and findings that have uncovered OT sites of action along pain processing pathways.
Current Status of Nerve Growth Factor Antibodies for the Treatment of Osteoarthritis Pain – free full-text /PMC6007861/ – Jun 2018
Blockade of nerve growth factor (NGF) with antibodies is a promising strategy for treatment of chronic pain associated with osteoarthritis (OA).
Promising according to who?
…all reported trials have been funded by the pharmaceutical industry and there are no independently funded trials listed in http://www.clinicaltrials.gov nor are there independent data.
This is the conundrum of drug development. Only those who stand to profit will pay for the expensive research and trials, yet those are exactly the entities most motivated to use “gamed” statistics and produce biased results. Continue reading
NERVE GROWTH FACTOR (NGF) BLOCKADE FOR THE MANAGEMENT OF OSTEOARTHRITIS PAIN: WHAT CAN WE LEARN FROM CLINICAL TRIALS AND PRECLINICAL MODELS? – free full-text /PMC5436144/ – Jan 2018
This article shows both the successes and problems with using anti-NGF drugs to control pain when we’re not exactly sure of all the other effects such a drug might have.
Purpose of review
Anti-NGF antibodies hold tremendous potential for the management of osteoarthritis (OA) pain, but clinical trials have revealed serious adverse effects that are incompletely understood.
This review discusses clinical trial results along with preclinical studies that have assessed NGF blockade in experimental OA, in order to provide insight for future studies. Continue reading
Pfizer And Lilly Preparing To Resume Phase 3 Chronic Pain Program For Tanezumab – March 23, 2015
Pfizer Inc. (NYSE:PFE) and Eli Lilly and Company (NYSE:LLY) announced today that they are preparing to resume the Phase 3 clinical program for tanezumab.
In the prior clinical studies of more than 11,000 patients, tanezumab demonstrated clinically meaningful efficacy vs. placebo and other select commonly used pain medicines.
I wonder what other “select commonly used pain medicines” it was tested against, when “commonly used” includes everything from aspirin and Tylenol to oxycodone. Continue reading
Complications of Uncontrolled, Persistent Pain – By Forest Tennant, MD, DrPH – Jan 2018
To the unfortunate patient who is afflicted and the practitioner who treats it, incurable, persistent pain is truly its own disease regardless of its underlying cause.
Persistent pain, which is also often characterized as chronic or intractable, has all the ramifications of a disease in that it may have pre-clinical and overt phases.
I like that he calls it “persistent pain” instead of “chronic pain”, a term which has become synonymous in the public’s eye as a whining, complaining, catastrophizing, gonna-be addict. Continue reading