Workshop : Neuroleptic and antidepressive drugs for chronic pain?

s190 THE MANAGEMENT Chairman:

OF THE DIFFICULT

Seymour Diamond

Diamond, Headache

MIXED HEADACHE

MD Clinic,

Chicago,

PATIENT IL

60625

285 Workshop Sun 4:OD

ti. 6. I

The patient with the mixed headache syndrome is probably the most difficult to manage. The diverse aspects of diagnosis, treatment and prognosis of this syndrome will be reviewed. Discussion of polypharmacology and psychological interaction will be included. Panelists:

Richard A. Sternbach, Pain Treatment Center, Scripps Clinic Research Foundation, La Jolla, CA 92037 - Psychological Management of the Difficult Mixed Headache Patient

and

Ninan T. Mathew, Houston Headache Clinic, Houston, TX 77004 - Polypharmacy in the Prophylactic Treatment of Chronic Recurrent Headache J.G. Edmeads, Department of Medicine (Neurology), University Toronto, Toronto, ONT, Canada - Myths in the Management of the Difficult Mixed Headache Patient

of

Jes Olesen, Department of Neuromedicine, Kfibenhavns amts Sygehus i Gentofte, 2900 Hellerup, Denmark - The Pathophysiology of Mixed Headache Patients

Workshop: ! 28: W;r$;hop NEUROLEPTIC AND ANTIDEPRESSIVE DRUGS FOR CHRONIC Harald Breivik, Oslo, Norway and PAIN?Chairmen: i G,1~~. iI Stephen Butler, Seattle, USA. The evidence for beneficial effects of neuroleptic drugs on chronic pain patients will be reviewed by Harold Merskey, London, Ontario, Canada: Results from animal experience, clinical impression from extensive use of neuroleptic drugs studies for chronic pain, as well as a few (too few) controlled indicate that neurolept drugs may be of benefit in chronic pain Recently completed studies with a non-sedative, low dose neuroleptic (flupentixol) with antidepressive and anxiolytic effects indicate that this drug may be particularly beneficial in chronic "benign" and cancer pain patients (H. Breivik). Other neuroleptic drugs may have depressive, sedative or autonomic sideeffects which limit their use in chronic "benign" pain patients. Evidence for beneficial effects of antidepressive drugs in the treatment of chronic pain patients will be reviewed by Stephen drugs have an even more Butler, Seattle, USA: Antidepressive msive record of traditional therapeutic usage in chronic "benign" pain and a strong clinical impression of beneficial effect in many patients. However, few controlled studies have been performed and some of these studies have given equivocal or negative results. Discussants of the neuroleptic drug and antidepressive drug issues will be J. Edmond Charlton, Newcastle-on-Tyne, UK and Issy Pilowsky, Adelaide, Australia.