I've been on 75 mg. of Plavix/day since a stent was put in a cardaic artery in 2005. I hadn't thought of it making any difference in the CRPS, but if stllaborette's testimonial is an indication if having some value, I wonder if it's making a difference with my RSD?

That said, I'm intrigued by Mrs. D's posting of information regarding calcium channel blockers, which may be worth looking into. But once again, the effectiveness of the treatment appears to be a function of how early it's given:

Complex regional pain syndrome (reflex sympathetic dystrophy and causalgia): management with the calcium channel blocker nifedipine and/or the alpha-sympathetic blocker phenoxybenzamine in 59 patients, Muizelaar JP, Kleyer M, Hertogs IA, DeLange DC, Clin Neurol Neurosurg. 1997 Feb;99(1):26-30.

Department of Neurosurgery, University of California, Davis, Sacramento 95817, USA.

Complex Regional Pain Syndrome (CRPS) is the new name for entities formerly known mostly as Reflex Sympathetic Dystrophy and Causalgia. Treatment of CRPS with either the calcium channel blocker nifedipine or the alpha-sympathetic blocker phenoxybenzamine was assessed in 59 patients, 12 with early stages of CRPS, 47 with chronic stage CRPS. In the early stage CRPS patients, 3 of 5 were cured with nifedipine and 8 of 9 (2 of whom had earlier received nifedipine) with phenoxybenzamine, for a cure rate of 92% (11 out of 12). In the chronic stage CRPS patients, 10 of 30 were cured with nifedipine; phenoxybenzamine cured 7 of 17 patients when administered as a first choice and another 2 of 7 patients who received nifedipine earlier, for a total late stage success rate of 40% (19 out of 47). The most common side effects necessitating discontinuing the drug were headaches for nifedipine and orthostatic dizziness, nausea and diarrhoea for phenoxybenzamine. All male patients on phenoxybenzamine experienced impotence, but this did not lead to discontinuing this agent and immediately disappeared after stopping the drug. These results once again stress the importance of early recognition of CRPS, and treatment with either of these drugs could be considered as a first choice for early CRPS, especially because in this series this treatment was not combined with physical therapy making it very cost-effective. In the chronic stage of CRPS, treatment with these drugs was much less successful (40%), even though it was always combined with physical therapy, but it can still be considered, either as a first choice or when other types of treatment have failed. [Emphasis added,]

PMID: 9107464 [PubMed - indexed for MEDLINE]

And, as to alpha-sympathetic blocker phenoxybenzamine referred to in the last abstract, see:

Treatment of complex regional pain syndrome type I with oral phenoxybenzamine: rationale and case reports, Inchiosa MA Jr, Kizelshteyn G, Pain Pract. 2008 Mar-Apr;8(2):125-32. Epub 2008 Jan 7, free full text at http://www.rsds.org/2/library/articl...izelshteyn.pdf.

Department of Pharmacology, New York Medical College, Valhalla, New York 10595, USA. mario_inchiosa@nymc.edu

The nonselective alpha-adrenergic antagonist, phenoxybenzamine, has been used in the treatment of neuropathic pain syndromes, specifically, complex regional pain syndrome (CRPS) types I and II. This agent has also previously been used in intravenous regional peripheral blocks for treatment of CRPS I; however, an intravenous preparation of phenoxybenzamine is not currently available in the U.S.A. In this case series, systemic administration was more appropriate for three of the four patients, as their syndromes had spread beyond the initial area of surgery or trauma. We report an apparent clinical benefit in three of the four patients following oral administration. We postulate that this may be due to the noncompetitive (irreversible) blockade of alpha(1)- and alpha(2)-adrenergic receptors. We further hypothesize that this blockade could reduce stimulation of an increased population of adrenergic receptors in hyperalgesic skin, blunt the stimulation by norepinephrine of alpha(2)-adrenergic receptors on macrophages, and ultimately reduce the release of proinflammatory cytokines from cellular elements.

PMID: 18194348 [PubMed - indexed for MEDLINE]

And while we may have gone over this before, for the reasons set forth in the first abstract, guys in particular would be have to be taking phenoxybenzamine only with their full and informed consent. (Talk about a trade off . . . .)

Mike