Hello everyone,
I recently started Lidcaine IV therapy for my EM. I was pain free for 1 week then 50% better week 2. Now back to all the same symptoms. Has anyone had success with these treatments?
hello cat lady, I have never used IV lidocaine, but was just discussing topical lidocaine (lidoderm patches) treatment vs or with topical ketamine. I have never tried the topical ketamine but I find that occasionally the lidoderm patches help alleviate some of the heat related pain. I'm curious though about the use of the lido in IV form vs IM or even sub-q, because lidocaine can be antiarrhythmic and can affect heart electrical conduction. can you (or anyone) explain the IV rationale? thanks, Linda
Hi,
Im desperate. im totally disabled .EM now widespread throughout body including scalp. Nothing works. Think aspirin therapy and supplements (mag, omega 3, vit D) may help tint bit - not sure. Decided to trial lidocaine IV infusion.Have accessed what paucity available in terms of research - not all empirical however and very contradictory. Rationale is is that lidocaine works as sodium channel blocker - implicated in EM
http://archderm.jamanetwork.com/article.aspx?articleid=478089 - Scott M. Kuhnert, MD; W. James Phillips, MD; Mark D. P. Davis, MB, MRCPI (1999) . Have copied you relevant excerpt below, but article insightful.
Erythromelalgia can be extremely recalcitrant to treatment. Although treatment with aspirin was initially reported to be the miracle cure for this disorder, clinical experience has not demonstrated high success rates in the majority of patients with erythromelalgia seen at our medical center. Patients who are resistant to aspirin therapy try a multitude of therapeutic modalities to control their pain,6 often without success.
In the case described here, an intravenous infusion of lidocaine was successful in treating the neuropathic pain associated with erythromelalgia; then mexiletine therapy was given orally. There was a profound improvement in the level of pain and an improvement in the manifestations of the syndrome, which coincided with the initiation of these medications. The patient also was also treated with tramadol and amitriptyline but had been taking these medications for some time without an improvement in his symptoms.
Local anesthetics such as lidocaine and mexiletine prevent or relieve pain by interrupting nerve conduction. Mexiletine is an oral analog of intravenous lidocaine (both class IB antiarrhythmia drugs) that shares the ability to block the sodium channel. Lidocaine and mexiletine have been used to treat neuropathic pain secondary to diabetic neuropathy, spinal cord injury, chronic pain syndromes secondary to peripheral nerve injury, fibromyalgia, and adiposis dolorosa (Dercum disease).7- 13 In clinical practice, lidocaine therapy given intravenously has been used as a predictor for response to mexiletine therapy given orally.
When administered systemically, mexiletine and lidocaine (both class IB antiarrhythmia drugs) may exert their analgesic effects via peripheral, central, or mixed mechanisms.14 Evidence is emerging that lidocaine and mexiletine may exert their antinociceptive effect through a central mechanism. Electrophysiologic studies aimed at elucidating the site at which lidocaine and tocainide exert their antinociceptive action provide compelling evidence in support of a central site of action.14- 16 With regard to a peripheral mechanism, animal models of nerve injury14,17- 20 and a model of phantom limb pain in humans21 seem to indicate that after nerve injury peripheral mechanisms may develop that are responsive to the blockade of sodium channels.
Our patient had profound relief of his pain after the lidocaine infusion and sustained relief once a therapeutic level of mexiletine was attained.
Other research on lidocaine treatment
https://www.medify.com/conditions/erythromelalgia
Have you read Dr Cohens work?. http://www.medicationsense.com/erythromelalgia.html
He lists several medications, antihistanmines, supplements that helped him. Im currently trying out each antihistamine - so far not much success.
Also the 5HTP test for serotonin
If you want to chat or discuss research message me.
Ill update you all re results of lidocaine and anything else - fingers crossed
God bless
Hi there,
Lidocaine IV stabilizes the electrical communication in nerves. The amide type of anesthetics (lidocaine is one ) does act within the sodium channels of the nerve membrane. Lidocaine can also effect other membranes that are excitable such as the brain and myocardium which is the muscular tissue of the heart. Lidocaine IV must be given under a doctor's supervision because if excessive amounts of the drug reach the body systemically it can affect the central nervous system and heart. But under supervision in a pain management clinic I would think and hope this would be well monitored. They usually start you out with a test dose and monitor the side effects.
There is a really amazing website I used to teach anatomy and some pharmacology/biology to my students. It is called Interactive Biology by Lesley Samuel. If you go to his site and enter V-gated sodium channels he has several videos that explain how this all works. And if you just want to watch some of the videos on his site they are really amazing in helping the average person understand the body.
I have my next treatment July 9th so will let everyone know how it goes.
Thanks.
lindaizias said:
hello cat lady, I have never used IV lidocaine, but was just discussing topical lidocaine (lidoderm patches) treatment vs or with topical ketamine. I have never tried the topical ketamine but I find that occasionally the lidoderm patches help alleviate some of the heat related pain. I'm curious though about the use of the lido in IV form vs IM or even sub-q, because lidocaine can be antiarrhythmic and can affect heart electrical conduction. can you (or anyone) explain the IV rationale? thanks, Linda