Painkillers Linked to Heart Rhythm Abnormalities Now Banned
Painkillers Darvon and Darvocet will be pulled from the market in light of new research linking the drug's active ingredient, propoxyphene, to serious—even fatal—heart rhythm problems, the Los Angeles Times reports. Doctors should stop prescribing the drugs, both of which are made by Xanodyne Pharmaceuticals. Patients taking the drugs should speak with their doctors immediately, and shouldn't make the decision to stop on their own, the U.S. Food and Drug Administration recommends. Any generic drugs containing propoxyphene must also be yanked off shelves. Friday's news shouldn't come as a complete surprise, though. Regulatory agencies in Britain and the European Union banned the ingredient more than a year ago, the Times reports. And in 2009, an FDA advisory panel voted 14-12 to pull the drug, but the FDA rejected the proposal, instead calling for a study of the drug's potential heart-related side effects. That study showed that, even in healthy patients, the drug increased the risk for potentially fatal heart arrhythmias, the Times reports.
For chronic pain sufferers, trying psychotherapy instead of painkillers might be an option, U.S. News's January Payne reported in 2009.
From: In Chronic Pain? You Might Need Psychotherapy
The services that a psychologist can offer—cognitive behavioral therapy and biofeedback, for example—can ease the misery by helping people learn to cope, says Robert Kerns, a professor in the department of psychiatry, neurology, and psychology at Yale University. Kerns was coauthor of a 2007 review published in Health Psychology that found psychological interventions to have a positive effect on the chronic low-back pain that afflicts at least 70 percent of adults at some point during their lifetimes. The review authors examined 22 studies and found that cognitive behavioral therapy and self-regulated treatments (such as biofeedback and hypnosis) eased pain intensity, improved quality of life, and reduced symptoms of depression.
People sometimes report chronic pain continuing for months or years after an injury, illness, or surgery. The original cause of the pain has healed, yet the person still hurts. And these people are not "manufacturing the pain," says Dave Patterson, professor of psychology in the department of rehabilitation medicine at Harborview Medical Center at the University of Washington.
There are several different mechanisms, he says—among them that when people stop moving and/or guard their bodies because of pain, even after they heal, the lack of movement and the way they guard their bodies can cause pain. Also, after someone has experienced pain for a long time, Patterson says, "the brain seems to become rewired so that it responds as if the person is in pain, even though the initial injury might have healed."
That's where psychological interventions can be useful. Besides cognitive behavioral therapy and biofeedback, treatments may include meditation, guided imagery, and hypnosis, among others. The goal, says David Bresler, president of the California-based Academy for Guided Imagery and founder of the UCLA Pain Control Unit, is to teach people how to relax, raise their tolerance to pain, and better manage the stresses in their life. These techniques "don't cause dependence or addiction," which can be a concern with narcotic pain medications, notes Bresler. "We believe that guided imagery," for example, can be used to elevate the "production and release of endorphins, the body's most powerful, natural pain relievers." Guided imagery, which involves focusing intently on relaxing images in your mind, has been used for treatment of pain, addictions, anxiety, phobias, panic disorders, cancer, depression, fertility problems, post-traumatic stress disorder, and other problems.
Psychological counseling can also foster good sleep habits, improve functioning and quality of life, and help people learn how to pace themselves. Many people with chronic pain say they feel worse when they sleep poorly or overdo it on work, school, or social activities. And "we do know that if people can reduce stress and sadness in their lives, learn to become physically active in a safe manner, and constructively alter the internal thoughts they have about their pain, that they can tolerate it much better regardless of its origin," Patterson says.
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