mrsD -

Thank you, thank you. Turns out, in the 1997 study by Muizelaar et al, cited above, they only got a 40% success rate in chronic CRPS cases with the sequential administration of what turns out to have been oral phenoxybenzamine: I just had to read the description of the earlier study in Inchiosa and Kizelshteyn, 2008, more carefully. Without phenoxybenzamine the "cure rate" with nifedipine alone was still a respectable 33%.

Which again raises the question of why at those odds aren't more doctors at least trying nifedipine, even if they have good reason to avoid Dibenzyline?

And what's really off is that when I just ran a PubMed search of "CRPS nifedipine," it came back with only result: the Muizelaar study. But then, searching under "RSD nifedipine" I got one relevant hit, a case report in Japanese. See, [A case report of reflex sympathetic dystrophy treated with nifedipine][Article in Japanese], Ohta S, Tanahashi T, Iida H, Asano T, Ueda N, Tani T, Suzuki A, Uematsu H, Yamamoto M, Masui 1989 May;38(5):679-83:

Reflex sympathetic dystrophy (RSD) refers to a symptom complex observed after nerve injury and consists primarily of severe burning pain associated with sensory, vasomotor and trophic phenomena. A 54-year-old male had undergone nephrectomy. At surgery left XIth intercostal nerve had been injured by cautery. After a few weeks following surgery, the patient developed progressive deep burning pain, stabbing sensation and dysesthesia in the left abdominal region. Analgesics and narcotics were ineffective. We diagnosed his case as RSD. He received nifedipine 10mg sublingually. Pain relief was obtained within 10min and lasted for 6hs. Consequently, nifedipine therapy was started at a daily dose of 30 to 60mg. His symptoms were markedly improved within 4 weeks. After 3 months his pain resolved. At the present, some pain often returns, but nifedipine is effective. Nifedipine may be useful as a drug for the management of reflex sympathetic dystrophy.

PMID: 2778955 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/2...ubmed_RVDocSum

The apparent lack of academic curiousity on the subject is amazing!

Mike