ANTIPSYCHOTICS FOR CHRONIC PAIN
One-third of Canadians suffer from chronic pain which may be due to compromised immune function and healing. Atypical antipsychotics such as olanzapine (Zyprexa), quetiapine (Seroquel), and risperidone (Risperdal) have been used to varying success to relieve chronic pain. But to be effective, these agents require concomitant administration of other agents: acetaminophen, NSAIDs, opiates, antidepressants (fluoxetine, sertraline, trazodone), anticonvulsants (gabapentin), benzodiazepines, and muscle relaxants (cyclobenzaprine).
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Olanzapine |
Quetiapine |
Risperidone |
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Pharmacology |
Dopamine, histamine, and adrenergic receptors |
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Neck pain from whiplash in car accident |
1.25mg twice a week up to 2.5mg daily at bed |
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Rheumatoid arthritis |
2.5mg at bed |
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Lower back from a fall |
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0.25mg to 0.5mg daily |
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Neck & back pain from spinal fusion |
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0.5mg to 1.5mg |
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Fibromyalgia |
2.5 to 20mg daily |
25 to 200mg daily |
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Headache |
2.5 to 10mg daily |
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Multiple pains (fibromyalgia, dysmenorrheal, migraine) |
Low dose |
25 to 50 mg at bed plus lamotrigine and escitalopram |
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Side effects |
Drowsiness, dizziness, fatigue, weight gain |
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