Current pain and headache reports
-
Although opioid analgesics are safe and effective tools for the treatment of moderate to severe pain, there remain large gaps in understanding of the effects of these drugs on the many dimensions of functioning. This article summarizes the biomedical evidence addressing cognitive effects of the opioid analgesics. Current evidence indicates that cognitive function can be influenced by use of opioid analgesics, although the effects vary between drugs, are thought to be most significant with mixed-activity drugs, codeine, propoxyphene, and meperidine, and are generally most concerning during the first few days after starting opioid therapy, before tolerance develops. Blanket policies regarding the activities of driving and working are inappropriate; this issue is best addressed on a patient-specific basis.
-
Curr Pain Headache Rep · Jan 2008
ReviewOccipital nerve stimulation for medically intractable headache.
There is an unmet need, and thus a continued search, for effective treatments for patients with chronic daily headache who do not respond to or tolerate conventional therapies. Recent interest has focused on the use of occipital nerve stimulation (ONS) to treat patients with chronic, disabling headaches who are not adequately controlled by usual therapies. ⋯ Electrical stimulation of the occipital nerve has both peripheral and central nervous system effects that modulate nociception. The exact role for ONS will evolve as our understandings of its physiologic effects, efficacy, and safety grow.