Category Archives: Trigeminal Neuralgia

Patching up Pain with a Lidocaine 5% Patch

Dear Pain Matters readers,

Treatment via a lidocaine 5% patch may offer significant pain relief for patients including cancer patients with focal nerve pain.

Specifically, patients with severe and localised nerve pain including one of the following painful conditions may benefit from a lidocaine 5% patch that topically delivers lidocaine:

  • Postherpetic neuralgia and herpes zoster (shingles);
  • Non-diabetic and diabetic peripheral neuropathy;
  • Trigeminal (orofacial) neuropathic pain;
  • Erythromelalgia;
  • Chronic low back pain (Hines et al, 2002);
  • Post-surgical neuropathic pain (e.g. following surgery for cancer or otherwise); and
  • Neuropathic pain directly attributable to cancer.

Lidocaine works by blocking sodium channels including Nav1.7 that underlie many nerve pain conditions (and other mechanisms).  The release of very small amounts of lidocaine transdermally via the patch ensures that motor and cardiac functions remain unaffected.

While topical lidocaine patches leads to pain relief in 29%-80% of treated patients, likely via small-fiber block, it is not clear why lidocaine patches may work better in some patients than in others (Krumova et al, 2012).

The topical lidocaine patch, measuring 10 cm X 14 cm, should only be applied on top of unbroken skin and where the pain is the greatest.  Patches should only be used by patients who are not allergic to local anaesthetics including lidocaine and who are not sensitive to the adhesive material itself.

The recommended maximum daily dose is 3 patches worn simultaneously for 12 hours at a time.  Since the lidocaine patch can only be worn for 12 hours at a time each day, other pain medications may be necessary, especially during sleep.

A Young Patient With Episodic Erythromelalgia In Both Feet

A 15-year old Caucasian girl who suffered disabling pain during episodes of erythromelalgia in both feet derived complete pain relief almost immediately after applying lidocaine 5% patches to the top of both of her feet, both at rest and during almost normal levels of activity.  

m_dce10009f2-3.png

Post-lidocaine patch treatment, the young patient was able to run around the track at school, play soccer, return to her physical education class, march in the school band and walk around the shopping mall for almost an hour.  As long as she did not overdo her activities, she was able to obtain 100% relief during the 12 hours of lidocaine patch use, plus another 2-3 hours after patch removal.  The patient slept without the patches.

Whilst offering complete local pain relief and no side effects, the lidocaine patch was unable to prevent the other symptoms of erythromelalgia from occurring including bright red skin and over-heated feet following physical exertion.

m_dce10009f1.png

(Davis & Sandroni, 2002, including both images).

Two (2) Patients With Neuropathic Pain Syndrome     

A 74-Year Old Female Patient With Herpes Zoster (Shingles)

Despite prompt treatment for a herpes zoster skin rash, a 74-year old woman developed stabbing and burning pain in her rash-affected area.  The patient was offered 2 lidocaine patches daily to cover the painful region.  Within 4 weeks treatment, the patient obtained 75% relief from pain caused by her herpes zoster skin rash.  Most of her systemic pain medications were stopped.

A 56-Year Old Male Patient With Severe Neuropathic Pain Syndrome Following Microsurgery For A Neuroma in Right Foot 

A 56-year old man suffered severe nerve pain shortly after microsurgery to his right foot due to an interdigital neuroma.  His painful symptoms included severe burning pain, mechanical hyperalgesia and allodynia, together with other symptoms.  As a result, he could no longer work, was unable to wear socks and shoes (only sandals) and withdrew from his family and friends.

After applying half of a lidocaine 5% patch daily onto his painful skin region, the patient reported positive results.  After 8 weeks of lidocaine patch treatment, the patient enjoyed an 80% reduction in overall pain levels and consequently returned to work.  There were no side effects and the patients was able to stop all other analgesics (Hans et al, 2010).

Trigeminal (Orofacial) Neuropathic Pain And Lidocaine Patch Treatment

A British study revealed that lidocaine 5% patch treatment led to improved pain levels in 12 of 14 trigeminal pain patients including oral surgery patients.  Nine (9) of the 12 patients were able to reduce or stop their intake of other pain medications.  Given that the majority (12/14) patients with trigeminal nerve pain benefited from lidocaine 5% patch treatment, further studies are warranted (Khawaja et al, 2013).

Cancer Patients And Lidocaine Patch Treatment

A large Australian study in a comprehensive cancer centre revealed that lidocaine 5% patch treatment had a ‘potent analgesic effect’ in 24 of 95 (25%) patients while another 23 patients (24%) reported a ‘partial effect’.  Given that almost half (47/95, or 49%) of all cancer patients with nerve pain benefited from lidocaine 5% patch treatment, further research is warranted (Fleming and O’Connor, 2009).

Current Study Involving Lidocaine Patch for Lower Limb Amputation Pain

A Belgium-based trial is currently recruiting up to 20 patients with pain following above- or below-knee amputation to assess the effectiveness of lidocaine patch treatment for peripherally-mediated phantom limb pain and/or stump scar hyperalgesia (Hatem, 2016).  Stay tuned for updates…

Summary

While lidocaine 5% patch treatment is expensive and there is a small risk of a skin rash, many patients with focal nerve pain obtain significant pain relief from the lidocaine 5% patch, a targeted peripheral analgesic that is non-addictive and safe for long-term use.  

Now that’s a good way to patch up pain!

Sabina Walker

Blogger, Pain Matters

REFERENCES

(1) Davis, Mark D P; Sandroni, Paola. Lidocaine Patch for Pain of Erythromelalgia; Arch Dermatol. Jan 2002;138(1):17-19

doi:10.1001/archderm.138.1.17

http://jamanetwork.com/journals/jamadermatology/fullarticle/478622

(2) Fleming JA, O’Connor BD.

Use of lidocaine patches for neuropathic pain in a comprehensive cancer centre.

(Utilisation des timbres de lidocaïne pour la douleur neuropathique dans un centre d’oncologie)

Pain Research & Management : The Journal of the Canadian Pain Society. 2009;14(5):381-388

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2779156/#!po=28.7879

(3) Hans G, Robert D, Verhulst J, Vercauteren M. Lidocaine 5% patch for localized neuropathic pain: progress for the patient, a new approach for the physician. Clinical pharmacology : advances and applications. 2010;2:65-70

doi: 10.2147/CPAA.S9795

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3262358/

(4) Hines R, Keaney D, Moskowitz MH, Prakken S. Use of Lidocaine Patch 5% for Chronic Low Back Pain: A Report of Four Cases. Pain Med 2002; 3 (4): 361-365

doi: 10.1046/j.1526-4637.2002.02051.x

https://academic.oup.com/painmedicine/article-lookup/doi/10.1046/j.1526-4637.2002.02051.x

(5) Khawaja N, Yilmaz Z, Renton T. Case studies illustrating the management of trigeminal neuropathic pain using topical 5% lidocaine plasters. British Journal of Pain. 2013;7(2):107-113.

doi:10.1177/2049463713483459

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4590123/#!po=23.6842

(6) Hatem, Samar; A Trial of Lidocaine Patch for Lower Limb Amputation Pain (Trial ongoing since 2016); Brugmann University Hospital

https://clinicaltrials.gov/ct2/show/study/NCT02696720?view=results

(7) Krumova EK1, Zeller M, Westermann A, Maier C. Lidocaine patch (5%) produces a selective, but incomplete block of Aδ and C fibers. Pain. 2012 Feb;153(2):273-80.

doi: 10.1016/j.pain.2011.08.020.

https://www.ncbi.nlm.nih.gov/pubmed/21995882

(8) Devers A, Galer BS. Topical lidocaine patch relieves a variety of neuropathic pain conditions: an open-label study. Clin J Pain. 2000 Sep;16(3):205-8.

https://www.ncbi.nlm.nih.gov/pubmed/11014393

(9) Many Other Lidocaine Patch/Pain Studies Can Be Found Here:

http://www.druglib.com/druginfo/lidoderm/abstracts/

External Laser Therapy and Laserneedle Acupuncture for Chronic Pain

Featured Image:   Comb Jelly (Mnemiopsis sp.)

https://i.ytimg.com/vi/weeFO6kLu5o/maxresdefault.jpg

Dear Pain Matters blog readers,

External laser therapy is used to exert various biological/cellular effects in the body including:

  • Stimulation of various acupuncture points (via noninvasive, painless Laserneedle acupuncture); and
  • Treatment of local damaged areas within the tissue.  Local laser therapy may be done for pain management, rehabilitation and regeneration of damaged tissue.

External laser therapy uses various laser wavelengths (i.e. colours) to penetrate different depths and tissues beneath the skin including:

  • Infrared laser (800 – 900 nanometers, ‘nm’; 810 nm, may be used) – 5 to 7 cm depth below the skin;
  • Red laser (630 – 680 nm; 658 nm may be used) – 2 to 3 cm depth below the skin.  Red laser can increase cellular activity and blood circulation as well as stimulate immune cells, fibroblasts and mitochondria, leading to regeneration and improved healing including wound healing;
  • Green laser  (532 nm) – 0.5 to 1 cm depth beneath the skin.  Green light is largely absorbed by haemoglobin in the red blood cells; and
  • Blue laser (405 nm) – 1 to 2 mm depth only.  Blue laser light has anti-inflammatory effects.

External laser therapy can be applied via:

  • Single point lasers.  Only one point and 1 wavelength can be used in single point lasers; or
  • Laserneedles.  Up to 12 multi-channel lasers/points including different wavelengths/colours/power outputs may be used at the same time (e.g. Weberneedle system, Lasershower).

External laser therapy may treat various painful medical conditions including:

  • Spine syndromes/back pain;
  • Osteoarthritis;
  • Rheumatoid diseases;
  • Tendon inflammation;
  • Migraine/headache; and
  • Trigeminal neuralgia

(Michael Weber MD).

95937076bf.png

Source:   http://www.webermedical.com/en/weber-medical-for-professionals/med-lasertherapy/external-laser-therapy/

Fibromyalgia:

A study involving laser acupuncture treatment for fibromyalgia patients reported an average Pain Scale of 4.4, post-laser acupuncture (compared to an average Pain Scale of 8.5, pre-laser acupuncture).

Further improvements occurred when laser acupuncture plus intravenous laser was offered to fibromyalgia patients (i.e. average Pain Scale of 2.9, post-laser acupuncture plus intravenous laser, compared to 8.9, pre-treatment).

Both:

  • Laser acupuncture; and
  • Laser acupuncture plus intravenous laser

were more effective for pain management than medication alone (6.8, post-medication, versus 8.7, pre-medication) and metal needle acupuncture (6.0, post-treatment, versus 8.5, pre-treatment) in fibromyalgia patients (Wieden).

(For more on intravenous laser, please refer to:
http://www.webermedical.com/en/weber-medical-for-professionals/med-lasertherapy/intravenous-laser-therapy/.)

Possible Mechanisms:

I urge all interested readers to read Chapter 4 called ‘Rewiring a Brain with Light’, in Norman Doidge’s 2nd book, ‘The Brain’s Way of Healing’.  This book provides an excellent introduction into phototherapy (i.e. low level laser therapy; LLLT) (Doidge, 2016).  

Scientists have recently shown that humans (including the human eye and brain) may detect and perceive a single photon (Tinsley et al, 2016).  This is very interesting as it shows the sensitivity of the human body to the biological (hence potential healing) effects of natural light including its visible wavelengths from 400 to 700 nm (blue to red) and invisible wavelengths from 800 to 900 nm (near infrared).

Summary:

Whilst relatively new (and undergoing further research), external laser therapy and Laserneedle acupuncture may be useful for reducing pain in many chronic pain conditions including fibromyalgia.

Dear Pain Matters blog readers, if you would like to get in touch with Dr Michael Weber and his team, please email Martin Junggebauer on:

junggebauer@webermedical.com

Martin is an integral member of Dr Michael Weber’s team, and he will be sure to assist you with your enquiries.

http://www.dr-weber-laser-clinic.com/en/home/

Sabina Walker

“Sedare dolorem divinum opus est”
“It is divine to alleviate pain”

Galen, 130-200 C.E.

REFERENCES

(1A) Michael Weber MD

Laser in Pain Therapy and Rehabilitation

http://www.webermedical.com/en/weber-medical-for-professionals/med-lasertherapy/pain-therapy-rehabilitation/

http://www.webermedical.com/en/the-business/dr-weber/

http://www.webermedical.com/en/weber-medical-for-professionals/the-principle/

(1B) Michael Weber MD, Robert Weber, Martin Junggebauer

Medical Low Level Laser Therapy – Foundations and Clinical Applications (2nd Edition, June 2015)

http://www.isla-laser.org/en/

(1C) Michael Weber MD, President of International Society for Medical Laser Applications (ISLA)

International Society for Medical Laser Applications (ISLA)

http://www.isla-laser.org/en/

(1D) Michael Weber MD, Thomas Fussgänger-May MD, Tillman Wolf MD

“Needles of Light”: A New Therapeutic Approach

Medical Acupuncture (2007); 19(3)

DOI: 10.1089/acu.2007.0539

http://www.my-dr.de/FG/texte/infounten/Publikationen/Medical_Acupuncture.pdf

(1E) Michael Weber MD, Zulia Frost MD

Multi-Laser Needle Acupuncture and Laser Blood Irradiation Therapy – Clinical Application of Biological Laser Therapy (Pages 1-50)

http://www.metgesacupuntors.org/resources/pdfs/congres_2009/17_30Z_Frost.pdf

Other Papers, Articles and a Blog by Fred Kahn, MD FRCS(C):

(2) Wieden, Torsten E. (MD Anaesthesiologist, Special pain therapy)

e-mail: wieden@schmerzpraxis-celle.de

Fibromyalgia in Pain Therapy – Mechanisms and Treatment Options in Laser Therapy

http://www.isla-laser.org/wp-content/uploads/Fibromyalgia-in-Pain-Therapy.pdf

(3) Pryor, Brian A

Class IV Laser Therapy – Interventional and Case Reports Confirm Positive Therapeutic Outcomes in Multiple Clinical Indications (2009)

http://www1.udel.edu/PT/PT%20Clinical%20Services/journalclub/caserounds/11-12/September/PryorLaserPromotional.pdf

(4) Class IV Laser Therapy – Case Study Reports (Pages 1-39)

http://www.madisonlasertherapy.com/uploads/6/4/3/2/6432749/class_iv_therapy_laser_case_studies_report_2013.pdf

(5) Litscher G, Rachbauer D, Ropele S, Wang L, Schikora D, Fazekas F, Ebner F.

Acupuncture Using Laser Needles Modulates Brain Function: First Evidence From Functional Transcranial Doppler Sonography and Functional Magnetic Resonance Imaging.

Lasers Med Sci. 2004;19(1):6-11.

DOI: 10.1007/s10103-004-0291-0

http://www.ncbi.nlm.nih.gov/pubmed/15316852

(6) Norman Doidge MD

The Brain’s Way of Healing – Remarkable Discoveries and Recoveries from the Frontiers of Neuroplasticity (Chapter 4 – Rewiring a Brain with Light)

Publisher: Penguin Publishing Group (26 January 2016)

ISBN: 9780143128373

http://www.normandoidge.com/?page_id=1042

(7) Blog by Fred Kahn, MD FRCS(C), LLLT Specialist

http://fredkahnmd.com/2016/07/12/current-research-on-the-management-of-pain/

(8) Tinsley JN et al

Direct detection of a single photon by humans.

Nat. Commun. 7:12172

doi: 10.1038/ncomms12172 (2016).

http://www.nature.com/articles/ncomms12172

 

 

Ziconotide (Prialt) User Reviews – The Fine Line Between Maximizing Pain Relief and Minimizing Severe Adverse Effects

Source of Featured Image:

https://en.wikipedia.org/wiki/Conus_magus

Dear Pain Matters blog readers,

Many nerve pain sufferers say they have tried EVERYTHING, to no avail.

The good news is that some patients with severe, intractable nerve pain obtain pain relief following Ziconotide (Prialt) treatment (while, sadly, others don’t).

Ziconotide (Prialt) is synthesized based on the venom of a marine snail called Conus magus.

For further details on Ziconotide (Prialt), please refer to literature including a paper by McGivern (2007).  You are also welcome to go to my earlier blog post, here:

https://painmatters.wordpress.com/2014/11/10/ziconotide-prialt-for-nerve-pain-including-crps/

BRIEF ANALYSIS OF ‘PRIALT USER REVIEWS’

An internet site called ‘Prialt User Reviews’ offers a collection of patient reviews:

http://www.rxlist.com/script/main/rxlist_view_comments.asp?drug=prialt&questionid=fdb92576_pem

The ‘Prialt User Reviews’  show that Prialt treatment may be a ‘hit-or-miss’ treatment for many patients with severe nerve pain.  Thus, while some severe nerve pain sufferers obtained significant pain relief from Prialt (that outweighed its side effects), many others were worse off due to Prialt’s severe side effects.

SOME POSITIVE ‘PRIALT USER REVIEWS’ 

A patient with low back pain commented:

“I did not realise how much this new drug helped me until I had to come off of it for a short period of time.”

Another pain patient wrote:

“I developed a BAD reaction to this med, even though it worked great for my pain.  Now I have all kinds of allergies and having trouble finding a med that is as effective without side effects.

A pain patient with 2 spinal operations wrote:

“Since I’ve had the pump, the pain is no longer in my legs.  I will be ever thankful to that little snail and its ooze.  God bless researchers.” 

A patient with chronic pain for over 10 years had a positive experience with Prialt.  In her own words, “…since I have been on these meds, things have turned around for the good….I thank God every day that I have my life back….”

Another pain patient stated:

“This for me has been a “life changing” positive experience.  I have been on the drug well over six years with NO side effects whatsoever….This has changed my life for the better as I am now able to do volunteer work…I had my occipital nerves sectioned as well as steroid-induced osteoporosis, so totally endorse this drug for neuropathic pain.”

A cancer survivor with chronic pain stated:

“My pain was due to cancer which is now in remission.  My first pain clinic pushed me too hard to increase Prialt and side effects were bad!  I heard music and it felt like my teeth were melting!  I kept reducing my Prialt until it was mixed w/a narcotic and that combination made my pain level from a constant 9 … to a livable 5-7!  This is the lowest my pain level has been in 9 yrs! … I am finally pleased with my Prialt and my Life.  After 8 years of trying different combinations and Prialt Levels and 1 pump reposition and 1 pump replacement, I am finally able to Live.  I can meet my husband for lunch most days ….Yes, it took several years to get the level just right and the side effects lower, but it was totally worth it to finally have a more normal and happy life!”

SOME NEGATIVE ‘PRIALT USER REVIEWS’ 

A patient with CRPS (RSD) for 8 years stated that Prialt is thebest at relieving pain BUT it’s not worth the side effects I get….several bad experiences and I always stuck it out since the relief was so good.  It’s no longer worth it.  I have no life, hardly leave the house and spend most of the time talking to myself’.

A former user said This medicine did help my nerve pain (moderately) but the memory loss is horrible.  I lost 50 lbs in 6 months.  I can’t concentrate well, agitated, no motivation, have extreme anxiety……I started having a pungent perfumey-like smell constantly, which started to become an obsession…..led up to a full blown manic episode …no sleep….thoughts of not wanting to live anymore….border-line psychosis….I’ve been off this medication for over 2 weeks now but still suffer from some of these side effects…..”

A pain patient who unsuccessfully underwent a Prialt trial wrote:

“…I started an IT pump trial with Prialt…..and the med was increased slowly (started out with about 4 mcg/day.  Increased eventually to about 7 mcg/day).  With the first increase, my pain improved (decreased).  With each successive increase of Prialt, my pain increased and so did side effects.  I became extremely dizzy, nauseated (with vomiting), confused, lethargic, my vision blurred, and I was unable to do anything but lie in bed and wonder what Prialt was doing to my brain…..”

IS DOSAGE AN ISSUE?

I find it very interesting that nerve pain levels did improve in several patients following Prialt treatment, despite severe side effects (see above).

Is it possible that the intrathecally-administered (spinally-administered) dosages were simply too high for those who suffered severe side effects, post-Prialt treatment?

Would nerve pain patients benefit from lower Prialt dosages for longer periods (before deciding to increase dosages)?  

Consider this example:

A 59-year old female with severe pain due to chronic trigeminal neuralgia (TN) pain underwent a single-shot trial of intrathecal ziconotide.  To reduce any adverse effects, the ziconotide dosage was intentionally kept very low, at only 1 mcg.  The patient’s TN pain levels dropped from ‘9’ to ‘6’ (that, unfortunately, returned to her original pain levels of ‘9’, 4 hours-post-ziconotide).  As such, 1 mcg/day ziconotide was added to her intrathecal combination of morphine and clonidine.  At this low dosage, the patient reported significant relief from TN, and (importantly!) no side effects (Michiels et al, 2011).

According to Webster (2005), to minimise adverse effects while also maximising pain relief, initial dosages must be very low and titrated very slowly.  Thus, for many patients, there is a fine balance between minimal adverse effects and maximal pain relief (Webster, 2005).

Ongoing studies are warranted to ascertain why Prialt treatment offers pain relief (with minimal side effects) for some nerve pain patients, but not for others.

Many patients had to stop using Prialt due to extreme, horrific, and intolerable side effects that included severe mental impairment, psychosis, personality changes, memory loss, hallucinations, minor to severe swelling of joints, tremors, paranoia, pain, bad mood swings, problems with sleeping, hearing loud music 24/7, confusion, anxiety attacks, depression, suicide risk, severe sinus infection, slurring speech, severe neurological symptoms, vision problems, severe weight loss, burning skin/electric shock sensations and allergies.  NB It is not clear whether some of the aforementioned side effects were solely caused by Prialt and/or due to other unknown factors.  Further studies of Prialt’s side effects are warranted.

Many studies into other novel drugs are underway (more later).

Wishing all pain patients less suffering and more hope.

Sabina Walker

PS  Please read the entire Prialt Patient Information Including Side Effects sheet before deciding to use Prialt.

http://www.rxlist.com/prialt-drug/patient-images-side-effects.htm

Also (quoting):

“Patient Comments are not a substitute for professional medical advice, diagnosis, or treatment…..”

http://www.rxlist.com/script/main/rxlist_view_comments.asp?drug=prialt&questionid=fdb92576_pem

PPS  It is important to note that not all Prialt users will offer feedback (positive or otherwise).  Furthermore, human nature tends to focus on the negative, rather than on the positive.  It is possible that many who obtain pain relief from Prialt choose not to post comments, while others who suffered severe side effects due to Prialt may offer feedback (to help others).

REFERENCES

(1) McGivern; Ziconotide: a review of its pharmacology and use in the treatment of pain; Neuropsychiatr Dis Treat. 2007; 3(1): 69–85.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2654521/

(2) RxList – The Internet Drug Index

Prialt User Reviews

http://www.rxlist.com/script/main/rxlist_view_comments.asp?drug=prialt&questionid=fdb92576_pem

(3) For more information on Prialt, please refer to:

http://www.rxlist.com/prialt-drug/consumer-uses.htm

http://www.rxlist.com/prialt-drug/patient-images-side-effects.htm

http://www.prialt.com

(4) Michiels et al; Trigeminal neuralgia relief with intrathecal ziconotide; Clin J Pain 2011; 27:352-354.

http://www.researchgate.net/publication/51052321_Trigeminal_neuralgia_relief_with_intrathecal_ziconotide

(5) Webster; Ziconotide in Complex Regional Pain Syndrome (2005)

http://rsds.org/ziconotide-in-complex-regional-pain-syndrome/

Oxytocin for Migraine and Headache?

Dear Pain Matters blog readers,

Oxytocin is a natural hormone made by the hypothalamus and released by the posterior pituitary gland.  Nicknamed the ‘love hormone’, or the ‘cuddle hormone’, oxytocin helps induce labor (during childbirth), as well as promote lactation, maternal care, and couple bonding.

The word oxytocin is derived from Greek for quick birth (‘oksys’ = quick and ‘tokos’ = birth).

Oxytocin for Migraine and Headache?

Did you know that oxycontin may also relieve pain in some chronic migraine and headache sufferers?

Nasal-administration of oxytocin bypasses the Blood-Brain Barrier and directly activates the oxytocin receptors in the trigeminal nerve.  These oxytocin receptors are increased during inflammation.

In a study involving 40 chronic migraine sufferers, half were given a nasal oxytocin agent called ‘TI-001’, while the other half were given placebo.  This study reported that 4 hours after nasal oxytocin (‘TI-001’) treatment, 27% of the migraine sufferers had nil pain. 

Interestingly, nasal oxytocin (‘TI-001’) is most effective in the presence of pain-evoking inflammation.

‘TI-001’ is now being developed for chronic and long-lasting headaches, migraines, trigeminal neuralgia, and other chronic facial and head pains.

http://trigemina.com/category/press-releases/

http://trigemina.com/product-pipeline/

Oxytocin’s Effects on the Autonomic Nervous System

A study found that intranasal oxytocin spray was able to increase heart rate variability in healthy men during rest (compared to placebo) (Kemp et al, 2012).  

A study showed that oxytocin enhances parasympathetic activity without affecting the sympathetic nervous system (Gamer and Büchel, 2012).

Summary

In summary, nasal oxytocin leads to:

(1) Activation of the trigeminal nerve and reduced pain in some migraine sufferers; and

 (2) Increased heart rate variability due to increased parasympathetic (vagal) activity. 

For more information, please listen to Psychologist Kelly McGonigal’s 14-minute speech on stress and oxytocin’s role in modulating the stress response.  Note: While pain is not discussed, oxytocin is specifically discussed by Kelly McGonigal from 7:50 on:

How to make stress your friend

Here’s to oxytocin…..that may help reduce pain and suffering caused by chronic migraines, headaches, etc!

Sabina Walker

REFERENCES

OXYTOCIN’S POSSIBLE PAIN-RELIEVING EFFECTS ON CHRONIC MIGRAINES AND HEADACHES

(1) Megan Talkington; New Possibilities for Pain Treatment
7th Annual Pain Therapeutics Summit showcases therapies in development (20 Feb 2014).

http://www.painresearchforum.org/news/37432-new-possibilities-pain-treatment

(2) Yeomans et al; Abstract P59 Therapeutic Effect of Nasal Oxytocin in Chronic Migraine: Dependence on Cytokines (in ‘Abstracts of the 2013 International Headache Congress’); Cephalalgia (June 2013); 33(8 Supplement); pages 58-59.

(3) Yeomans; In the Pipeline: Nasal Oxytocin Explored for Migraines- Can migraine patients trust the “trust drug” to heal their pain? Practical Neurology (May/June 2013); 29-31.

http://practicalneurology.com/pdfs/PN0513_Pipeline.pdf

(4) Phillips et al; Relief of acute migraine headache with intravenous oxytocin: report of two cases. J Pain Palliat Care Pharmacother (2006); 20(3):25-8.

http://www.ncbi.nlm.nih.gov/pubmed/16931475

(5) Wang et al; The interaction between the oxytocin and pain modulation in headache patients. Neuropeptides (April 2013);47(2):93-7.

doi: 10.1016/j.npep.2012.12.003.

http://www.ncbi.nlm.nih.gov/pubmed/23375440

OXYTOCIN’S EFFECTS ON THE AUTONOMIC NERVOUS SYSTEM AND INFLAMMATION

(6) Kemp, Quintana, Kuhnert, Griffiths, Hickie, Guastalla; Oxytocin Increases Heart Rate Variability in Humans at Rest: Implications for Social Approach-Related Motivation and Capacity for Social Engagement; PLOS One (28 August, 2012); 7(8); e44014 (pages 1-6).

DOI: 10.1371/journal.pone.0044014

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0044014

(7) Gamer, Büchel; Oxytocin specifically enhances valence-dependent parasympathetic responses. Psychoneuroendocrinology (Jan 2012);37(1):87-93.

doi: 10.1016/j.psyneuen.2011.05.007. Epub 2011 Jun 8.

http://www.ncbi.nlm.nih.gov/pubmed/21641726

(8) Szeto et al; Oxytocin administration attenuates atherosclerosis and inflammation in Watanabe Heritable Hyperlipidemic rabbits; Psychoneuroendocrinology (May 2013); 38(5):685-93.

doi: 10.1016/j.psyneuen.2012.08.009.

http://www.ncbi.nlm.nih.gov/pubmed/22998949