A little diversion from creative cosmetics. Why ? Well those of you who know me will know that I had to retire from full time NHS work because of complex regional pain syndrome (CRPS) and depression. Thanks to advances in medical therapy I am much much better.
As a pharmacist, I did understand the medication but taking them was another experience. Here are some thoughts :-
A cocktail of medications can allow you to select from medications with different actions. This was the pain is challenged from all sites. Taking a number of medications might reduce your chance of side effects from a single one. Many CRPS will be taking pregabalin or gabapentin which reduce how we perceive pain. They are difficult medications to take. I advise start really low and increase every 3 to 5 days, take the bigger dose at night. The dreadful sleepiness will wear off after 3 to 4weeks. If you can bare it keep taking, although some just cant .
#pregabalin #gabapentin #CRPS #pain #neuropathic #doctor #pharmacist #painconsults
Pregabalin versus Gabapentin in Chronic Pain and CRPS
Is one better than the other ? As far as I am aware, the answer is we don't really know. Some of the differences are :-
1. Gabapentin is more cost-effective (cheaper). Its license is epilepsy and neuropathic (nerve)pain
2. Pregabalin is slightly more expensive. It is licensed for epilepsy, neuropathic pain and generalised anxiety disorder.
3. Gabapentin can be taken up to 4 times a day.
4. Pregabalin should be taken twice a day. Although I usually take it 3 times a day.
5. Pregabalin has better GI absorption.
6. Pregabalin has more abuse potential. It is used by opioid (heroin , fentanyl, morphine, oxycodone and more) to prolong the action of the opioid
7. I have yet to find a chronic pain or CRPS patient who 'loves' effect of pregabalin. It is my clinical impression that you do not observe this in chronic pain and CRPS.
8. Both are addictive. This means that one has to reduce the dosage gradually. For example if you are taking pregabalin 900mg over a day and wish to reduce. Try going very slowly-reduce to 850mg first and wait one or two weeks. I think you will notice an effect, although beware of rebound pain.
9. Gabapentin and pregabalin have shown in studies to be highly effective in reducing one's perception of neuropathic pain. That is the pain is still there , yet we do not notice as much, many say they are so effective that they always know when next dose is due.
10. They are possibly the most effective medication and should be tried in combination with other.
11.They are difficult medicines to take and some simply cant tolerate them.
1. Chang C, McDonnell P, Eric Gershwin M. Complex regional pain syndrome – False hopes and miscommunications. Autoimmun Rev. 2019;(October 2018):1-9. doi:10.1016/j.autrev.2018.10.003
#pain #expert #pharmacist #doctor #CRPS #persistent-pain #chronic-pain