Calcitonin in Phantom Limb Pain

@inproceedings{Wall1999CalcitoninIP,
  title={Calcitonin in Phantom Limb Pain},
  author={Geoffrey C Wall and Catherine A. Heyneman},
  booktitle={The Annals of pharmacotherapy},
  year={1999}
}
PLP is a challenging disorder that is often difficult to treat. Like all other types of pain, PLP is a tremendous source of morbidity and should be treated aggressively. Though evidence is very limited, one or two doses of intravenous salmon calcitonin 200 IU may be an effective treatment. The minor adverse effects reported in the literature would seem to indicate the relative safety of this regimen; however, clinicians should be aware of the rare but severe hypersensitivity reactions that can… 
Use of calcitonin in recalcitrant phantom limb pain complicated by heterotopic ossification
TLDR
This study details the management of phantom limb pain in a 72-year-old man, in whom comorbid heterotopic ossification was present, and provides a review of the literature regarding phantom limbPain management and the current understanding of heterotopy ossifying and its possible link to peripheral nerve injury.
Calcitonin for phantom limb pain in a pregnant woman.
  • T. Turek, A. Wigton
  • Medicine
    American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists
  • 2012
TLDR
Reduction in the frequency of PLP attacks and a lessening of pain intensity were observed after administration of calcitonin (salmon) by i.v. infusion in a pregnant patient and was not associated with any apparent long-term adverse effects to the patient or infant.
Methadone for Phantom Limb Pain
TLDR
Administration of oral methadone may be of value in the treatment of phantom limb pain; controlled clinical trials would be appropriate to verify this observation.
Phantom limb pain as a manifestation of paclitaxel neurotoxicity.
TLDR
2 patients with prior amputation who experienced phantom limb pain (PLP) after receiving paclitaxel therapy and a third patient experienced disabling neurotoxicity in the extremity of a prior ulnar nerve and tendon transposition after receivingpaclitaxe.
Highly Bioavailable Nasal Calcitonin - Potential for Expanded Use in Analgesia
TLDR
Increased systemic bioavailability is expected to increase the clinical usefulness of calcitonin as a safe, noninvasive, non-opioid, analgesic in a number of important underserved clinical indications.
Pain management in new amputees: a nursing perspective.
TLDR
The authors aimed to improve the management of patients undergoing amputation at their institution, by ensuring accurate and holistic assessment, the selection of suitable interventions through critical analysis and synthesis of available evidence, and the appropriate evaluation and adaptation of treatment plans, to ensure patients achieved their individualised goals.
Analgesic effect of calcitonin in osteoporosis.
TLDR
There is mounting evidence that calcitonin significantly reduces bone pain in osteoporosis, and that the analgesic effect can be evident as soon as the second week of treatment, and the limitations to the use of calciton in patients with vertebral crush fractures can now be overcome by the availability of the nasal spray preparation.
Case Report Methadone for Phantom Limb Pain
TLDR
Administration of oral methadone may be of value in the treatment of phantom limb pain; controlled clinical trials would be appropriate to verify this observation.
Adjunctive pharmacological management of persistent, nonmalignant pain in older individuals
TLDR
Oral antiepileptic drugs, mexiletine, baclofen, tricyclic antidepressants, selective serotonin–norepinephrine dual reuptake inhibitors and intranasal/injectable calcitonin are the subjects of this review of the management of persistent, nonmalignant pain in the elderly.
A review of the management of phantom limb pain: challenges and solutions
TLDR
No decisions can be made for the first-line management of PLP, as the level of evidence is too low, and robust studies on homogeneous populations, an understanding of what amputees consider a meaningful reduction in PLP and agreement of whether pain intensity is the legitimate therapeutic target are urgently required.
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References

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TLDR
Calcitonin in a single-shot treatment to patients with persistent or acute phantom limb pain responded immediately and noted a clear analgesic effect, and it is believed that this could be an exciting new approach to the treatment of phantom limbPain.
Calcitonin in phantom limb pain: a double-blind study
TLDR
S‐CT is a valuable treatment for PLP in the early postoperative period in patients who had undergone major amputations and developed severe PLP 0–7 days after surgery.
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TLDR
This article reports a series of 31 patients with true phantom pain, used in an open-label study to evaluate its effectiveness in the treatment of this disorder, that had good to excellent results with mexiletine alone and with a combination of the drug alone and clonidine.
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TLDR
The theoretical aspects of the pathophysiology of postamputation phantom pain, which seems to be produced by a complex multifactorial interaction between the peripheral, sympathetic, and central nervous systems, are reviewed.
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TLDR
The physiological role of calcitonin is the preservation of osseal integrity by reducing the osteoclast activity and this 32 amino acid peptide acts as an analgetic drug in cancer caused by osteolytic metastases, and it was decided to compare the pain reducing activity of nasal spray with the ampule form.
Equivalence of Nasal Spray and Subcutaneous Formulations of Salmon Calcitonin
TLDR
Equivalence of the two formulations, was demonstrated and local safety of INSCT was similar to that of its placebo, which is considered to be clinically pertinent.
Phantom Limb Pain. A Review
  • N. Postone
  • Medicine
    International journal of psychiatry in medicine
  • 1987
TLDR
The characteristics and time course of phantom limb pain are well described in the literature, but no single theoretical approach can fully account for the contradictory aspects of this condition, thus its underlying mechanisms remain unclear.
Intravenous calcitonin alleviates spinal anesthesia-induced phantom limb pain.
TLDR
A patient in whom PLP, induced by spinal anesthesia, ceased abruptly with a single dose of intravenous calcitonin is described.
Suggested guidelines for treatment of phantom limb pain
TLDR
A diagnostic and therapeutic schemata is presented, which incorporates the above surveys, research, and clinical experience into a unified approach optimizing the few treatments showing a reasonable hope of long term success.
Long-term use of narcotic/antidepressant medication in the management of phantom limb pain
TLDR
Narcotics can be safely and successfully utilized for long‐term management of phantom limb pain and there were no signs of habituation or addiction.
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