MZS:Pain management

Miscellaneous Herbs

• Kratom

• Opioid
• Dissociative

• Kava kava

• GABAergic
• Cannabinoid

• Cat's claw

• Dissociative

• Cannabis

• Cannabinoid
• Opioid

Cannabinoids

• THC
• CBD
• CBN

Muscle relaxants

• Methocarbamol
• Baclofen
• Gabapentin

NSAIDs

• Naproxen
• Ibuprofen

Opiates

Opiates can have drastically varying effects depending on which receptors they interact with, for example.

• δ-opioid receptor

- Agonism is thought to be useful for treatment of chronic pain with minimal psychoactive effects

• μ-opioid receptor

- Agonism is helpful with more temporary acute pain, additionally causing euphoria. Negative side effects include nausea and itching

• κ-opioid receptor

- κ-opioid agonism has a highly potent analgesic effect as well as suppressing the itching side effect of μ-opioid, though negative side effects include dysphoria, hallucinations, and dissociation. It is known to be a component in causing many the effects associated chronic stress.

- conversely antagonism has shown promise in suppressing many of the negative symptoms of opiate withdrawal through antidepressant and anxiolytic effects. As such κ-opioid antagonists may have use in treating central central sensitization caused by chronic pain.

NMDA antagonists

NMDA antagonists are often used for clinical anesthesia and also appear in some herbs commonly used as DIY remedies (Kratom, Cat's claw). That said more powerful agents may not be viable as a long term solution due to their hallucinogenic effects at large enough doses, but research has begun to show a lingering antidepressant effect after larger doses which may lead to their use as novel therapeutic agents in a clinical setting.

Nootropics

Some nootropics have shown efficacy in preventing and reversing neuropathic pain in rats, and this effect may extend to humans - as well as other compounds of the same classes (choline sources and racetams).

• Citicholine
• Piracetam

Antidepressants

Depression and chronic pain are known to mutually cause similar negative neuroplastic changes to the central nervous system, leading to common the common long term effect of hypersensitivity to pain (central sensitization). Due to this common source these symptoms can often be treated together using antidepressants.

Cognitive Behavioral Therapy

Cognitive behavioral therapy has also shown some efficacy in the treatment of central sensitization which may be partially implicit in the musculoskeletal pain associated wit EDS.