post stroke pain

[Pain_doc]

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Posted in the pain forum and it was suggested to post in this forum as well: seeing a patient that had a stroke last May. Pain in upper and lower extremities started 2-3 months later. The hand and finger pain the worst. She's on lyrica 600mg/day, trazodone, zoloft. Tried cymbalta in past. Any body got new ideas about post stroke pains? thanks.

 

[100YardDash]

How about adding elavil to the lyrica? dose it at night at 75mg qHs and take away the trazodone. Sympathetic dysfunction is thought to play a role in central pain as well… Can consider clonidine too. Can get pain involved and do IV lidocaine maybe? of course in addition to TENs, US, etc. Just a thought.

 

[Taus]

How about adding elavil to the lyrica? dose it at night at 75mg qHs and take away the trazodone. Sympathetic dysfunction is thought to play a role in central pain as well… Can consider clonidine too. Can get pain involved and do IV lidocaine maybe? of course in addition to TENs, US, etc. Just a thought.

Elavil in a likely older stroke patient? Careful....

 

[lobelsteve]

Elavil in a likely older stroke patient? Careful....

Especially to recommend starting it over 10mg dose.