Chronic Pain Whatever the cause, support for managing long term or intractable pain.


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Old 10-06-2011, 06:23 PM #11
kittycapucine1974
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Hi, Dr. Smith:

No, Dr. Smith. I have absolutely no doubt that it was naltrexone, not naloxone, that was used in some fentanyl patches during the clinical trial in which I participated.

Take a look at this (I hope the link works); I was part of a similar clinical trial done a few years earlier:

http://www.clinicaltrialsfeeds.org/c...ow/NCT00650182

If the link does not work, you will have to type the link in the box starting with http://www. (I do not know the technical name for that box).

Read what you see on this page. Then click on:

Click here to view the journal abstract from the study manuscript.

You will be able to see and read the Protocol Final Report.

Quote: "As I understand it, they should have brought your opioid levels down considerably before trying this, and even then there is a specific protocol that must be adhered to and carefully monitored. Somebody (and possibly more than one) messed up." This is also what I think. At the time of the clinical trial I participated in a few years ago, I was on the 75 mcg dosage of Duragesic.
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Old 10-06-2011, 10:40 PM #12
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Quote:
Originally Posted by kittycapucine1974 View Post
Hi, gabbycakes:

Quote: "I just googled this medication and I don't understand why it is used together with opioids." I personally think that naltrexone should not be used with opioids like fentanyl because these opioids will become ineffective because of naltrexone. The fentanyl patch withdrawal symptoms caused by naltrexone are pure hell. I felt so sick I could not swallow anything without vomiting bile and I thought I was going to die. I was not depressed at that time, so these thoughts of impending death were not caused by depression.

I think that when naltrexone blocks the effects of a certain family of opioids, called opioid agonists, it blocks their bad effects (respiratory depression on those who abused opioid agonists by taking too much of them, voluntarily or not) and it blocks their good effects (pain killing effects).

As long as you do not mix this type of medication (opioid agonists, such as fentanyl, oxymorphone, hydromorphone, morphine, hydrocodone, and codeine) with medications such as naltrexone, you have nothing to fear. You will still benefit from the pain killing effects of the opioids. Your doctor can reassure you.
Hi,

Thank you for the response. But honestly I don't have any idea of starting any of these medications. I have RSD and have seen the good, bad and the ugly of narcotics. And I have taken the approach the less the better and honestly I feel better. To be fair I was diagnosed just around 8 months of on-set of RSD and had very aggressive treatments,3 - 5 day in-patinet infusions with boosters,many Stellate ganglion blocks, many different medications and other modalities I can't even remember. But I the ketamine is what stopped it in it's tracks. I haven't done a booster since January 09. I also had a top Pain Managment doctor in NYC who was the smartest doctor I have ever met. I think god just was on my side. Hope you are feeling better.

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Old 10-07-2011, 08:38 AM #13
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Quote:
Originally Posted by kittycapucine1974 View Post
No, Dr. Smith. I have absolutely no doubt that it was naltrexone, not naloxone, that was used in some fentanyl patches during the clinical trial in which I participated.
Three things:

1. The first link works fine; the second, detailing the final report, does not.

2. My recollection is apparently deficient; this could be from initial misunderstanding or memory problems. My apologies - I need to review this stuff.

3. I now think your reaction may have been just that - some kind of bad reaction - and perhaps not a withdrawal, but I sure don't know fer sure.

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Old 10-07-2011, 02:34 PM #14
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Hi, gabbycakes:

Quote: "And I have taken the approach the less the better and honestly I feel better." I wish I would be as lucky as you are. My narcotic painkillers (Duragesic 125 mcg and MSIR 30 mg) seem to be losing some effectiveness; this really saddens me because I wonder about what will happen to me if these painkillers lost completely their effectiveness.

I was diagnosed about nine months after the car injured me but, unlike you, I did not have the chance of benefiting from very aggressive treatments. I could not get nerve blocks or ketamine infusions just because I could not afford them. I dream of, someday, following in your steps.

Quote: "I think god just was on my side." If God was on your side, then His enemy, the devil, must have been on mine because nothing good happened with my RSD. Not only it did not go away; it spread to my whole body and is attacking my internal organs now. It already attacked my thyroid and lungs; I fear what is going to happen when RSD attacks my heart.
Hope you are feeling better.
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Old 10-07-2011, 02:50 PM #15
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Hi, Dr. Smith:

Once you click on the first link, go all the way down the page and you will find something saying "Click here to view the journal abstract from the study manuscript." You can click on the second link from this page, not from the Neuro Talk page (which was only for informative purposes). You have to have Acrobat Reader to open this pdf document. I tried this morning from my computer and it worked.

Quote: "I now think your reaction may have been just that - some kind of bad reaction - and perhaps not a withdrawal, but I sure don't know for sure." I am not sure if my problems with the fentanyl patches with the naltrexone were caused by a bad reaction or withdrawal.

Last edited by kittycapucine1974; 10-07-2011 at 02:52 PM. Reason: Correction
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Old 11-24-2011, 02:57 AM #16
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Just thought I'd follow up about the low dose naltrexone.

It is off label use, my Dr. did disclose that to me. I have severe neuropathic burning pain all over my body and severe neuropathic itching too. I did one month of LDN and it was not a success for me. I had read alot about how it was this wonder drug for pain, but unfortunately it was not for me.

BTW, I use Vicodin for foot pain, and my vicodin DID NOT work when I was on the LDN.
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