Topical amitriptyline-ketamine for treatment of rectal, genital, and perineal pain and discomfort

Timothy J. Poterucha, Sinead L. Murphy, Richard H. Rho, Paola Sandroni, Roger A. Warndahl, William T. Weiss, Mark D P Davis

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background: Pain in the rectal, genital, and perineal area is a common condition treated by pain physicians. These chronic pain syndromes are therapeutically challenging because both interventional and drug therapies often are ineffective. Objectives: To determine if pelvic pain can be treated effectively with compounded topical amitriptyline-ketamine. Study Design: A retrospective review of medical records. Setting: A single academic medical center in the United States. Methods: We identified all patients treated with topical amitriptyline-ketamine from January 1, 2004, through November 28, 2011. Medical records were evaluated to determine the diagnosis for which the medication was prescribed. Treatment efficacy and any adverse effects were recorded. Results: Of the 1,068 patients who received amitriptyline-ketamine, 13 had the medication prescribed for genital, rectal, or perineal pain and had medication efficacy recorded. Of these 13 patients, one (8%) had complete relief, 6 (46%) had substantial relief, 4 (31%) had some relief, and 2 (15%) had no response. One patient reported occasional irritation while using topical amitriptyline-ketamine with lidocaine; no other patients reported local or systemic adverse effects. Limitations: Retrospective review; lack of uniform system for pain grading; concurrent use of other medications. Conclusions: Topical amitriptyline-ketamine provided a high rate of pain relief with a low adverse-effect burden in patients with pelvic pain. This topical medication could offer an effective, noninvasive, nonopioid therapy for pain in the rectum, perineum, and genitals.

Original languageEnglish (US)
Pages (from-to)485-488
Number of pages4
JournalPain Physician
Volume15
Issue number6
StatePublished - Nov 2012

Fingerprint

Amitriptyline
Ketamine
Pain
Pelvic Pain
Medical Records
Therapeutics
Perineum
Lidocaine
Rectum
Chronic Pain
Physicians
Drug Therapy

Keywords

  • Amitriptyline
  • Compounded medication
  • Genital
  • Ketamine
  • Pain
  • Pelvic
  • Perineal
  • Rectal

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Poterucha, T. J., Murphy, S. L., Rho, R. H., Sandroni, P., Warndahl, R. A., Weiss, W. T., & Davis, M. D. P. (2012). Topical amitriptyline-ketamine for treatment of rectal, genital, and perineal pain and discomfort. Pain Physician, 15(6), 485-488.

Topical amitriptyline-ketamine for treatment of rectal, genital, and perineal pain and discomfort. / Poterucha, Timothy J.; Murphy, Sinead L.; Rho, Richard H.; Sandroni, Paola; Warndahl, Roger A.; Weiss, William T.; Davis, Mark D P.

In: Pain Physician, Vol. 15, No. 6, 11.2012, p. 485-488.

Research output: Contribution to journalArticle

Poterucha, TJ, Murphy, SL, Rho, RH, Sandroni, P, Warndahl, RA, Weiss, WT & Davis, MDP 2012, 'Topical amitriptyline-ketamine for treatment of rectal, genital, and perineal pain and discomfort', Pain Physician, vol. 15, no. 6, pp. 485-488.
Poterucha TJ, Murphy SL, Rho RH, Sandroni P, Warndahl RA, Weiss WT et al. Topical amitriptyline-ketamine for treatment of rectal, genital, and perineal pain and discomfort. Pain Physician. 2012 Nov;15(6):485-488.
Poterucha, Timothy J. ; Murphy, Sinead L. ; Rho, Richard H. ; Sandroni, Paola ; Warndahl, Roger A. ; Weiss, William T. ; Davis, Mark D P. / Topical amitriptyline-ketamine for treatment of rectal, genital, and perineal pain and discomfort. In: Pain Physician. 2012 ; Vol. 15, No. 6. pp. 485-488.
@article{ad335ac39db746b9a572cebb40afa67e,
title = "Topical amitriptyline-ketamine for treatment of rectal, genital, and perineal pain and discomfort",
abstract = "Background: Pain in the rectal, genital, and perineal area is a common condition treated by pain physicians. These chronic pain syndromes are therapeutically challenging because both interventional and drug therapies often are ineffective. Objectives: To determine if pelvic pain can be treated effectively with compounded topical amitriptyline-ketamine. Study Design: A retrospective review of medical records. Setting: A single academic medical center in the United States. Methods: We identified all patients treated with topical amitriptyline-ketamine from January 1, 2004, through November 28, 2011. Medical records were evaluated to determine the diagnosis for which the medication was prescribed. Treatment efficacy and any adverse effects were recorded. Results: Of the 1,068 patients who received amitriptyline-ketamine, 13 had the medication prescribed for genital, rectal, or perineal pain and had medication efficacy recorded. Of these 13 patients, one (8{\%}) had complete relief, 6 (46{\%}) had substantial relief, 4 (31{\%}) had some relief, and 2 (15{\%}) had no response. One patient reported occasional irritation while using topical amitriptyline-ketamine with lidocaine; no other patients reported local or systemic adverse effects. Limitations: Retrospective review; lack of uniform system for pain grading; concurrent use of other medications. Conclusions: Topical amitriptyline-ketamine provided a high rate of pain relief with a low adverse-effect burden in patients with pelvic pain. This topical medication could offer an effective, noninvasive, nonopioid therapy for pain in the rectum, perineum, and genitals.",
keywords = "Amitriptyline, Compounded medication, Genital, Ketamine, Pain, Pelvic, Perineal, Rectal",
author = "Poterucha, {Timothy J.} and Murphy, {Sinead L.} and Rho, {Richard H.} and Paola Sandroni and Warndahl, {Roger A.} and Weiss, {William T.} and Davis, {Mark D P}",
year = "2012",
month = "11",
language = "English (US)",
volume = "15",
pages = "485--488",
journal = "Pain Physician",
issn = "1533-3159",
publisher = "Association of Pain Management Anesthesiologists",
number = "6",

}

TY - JOUR

T1 - Topical amitriptyline-ketamine for treatment of rectal, genital, and perineal pain and discomfort

AU - Poterucha, Timothy J.

AU - Murphy, Sinead L.

AU - Rho, Richard H.

AU - Sandroni, Paola

AU - Warndahl, Roger A.

AU - Weiss, William T.

AU - Davis, Mark D P

PY - 2012/11

Y1 - 2012/11

N2 - Background: Pain in the rectal, genital, and perineal area is a common condition treated by pain physicians. These chronic pain syndromes are therapeutically challenging because both interventional and drug therapies often are ineffective. Objectives: To determine if pelvic pain can be treated effectively with compounded topical amitriptyline-ketamine. Study Design: A retrospective review of medical records. Setting: A single academic medical center in the United States. Methods: We identified all patients treated with topical amitriptyline-ketamine from January 1, 2004, through November 28, 2011. Medical records were evaluated to determine the diagnosis for which the medication was prescribed. Treatment efficacy and any adverse effects were recorded. Results: Of the 1,068 patients who received amitriptyline-ketamine, 13 had the medication prescribed for genital, rectal, or perineal pain and had medication efficacy recorded. Of these 13 patients, one (8%) had complete relief, 6 (46%) had substantial relief, 4 (31%) had some relief, and 2 (15%) had no response. One patient reported occasional irritation while using topical amitriptyline-ketamine with lidocaine; no other patients reported local or systemic adverse effects. Limitations: Retrospective review; lack of uniform system for pain grading; concurrent use of other medications. Conclusions: Topical amitriptyline-ketamine provided a high rate of pain relief with a low adverse-effect burden in patients with pelvic pain. This topical medication could offer an effective, noninvasive, nonopioid therapy for pain in the rectum, perineum, and genitals.

AB - Background: Pain in the rectal, genital, and perineal area is a common condition treated by pain physicians. These chronic pain syndromes are therapeutically challenging because both interventional and drug therapies often are ineffective. Objectives: To determine if pelvic pain can be treated effectively with compounded topical amitriptyline-ketamine. Study Design: A retrospective review of medical records. Setting: A single academic medical center in the United States. Methods: We identified all patients treated with topical amitriptyline-ketamine from January 1, 2004, through November 28, 2011. Medical records were evaluated to determine the diagnosis for which the medication was prescribed. Treatment efficacy and any adverse effects were recorded. Results: Of the 1,068 patients who received amitriptyline-ketamine, 13 had the medication prescribed for genital, rectal, or perineal pain and had medication efficacy recorded. Of these 13 patients, one (8%) had complete relief, 6 (46%) had substantial relief, 4 (31%) had some relief, and 2 (15%) had no response. One patient reported occasional irritation while using topical amitriptyline-ketamine with lidocaine; no other patients reported local or systemic adverse effects. Limitations: Retrospective review; lack of uniform system for pain grading; concurrent use of other medications. Conclusions: Topical amitriptyline-ketamine provided a high rate of pain relief with a low adverse-effect burden in patients with pelvic pain. This topical medication could offer an effective, noninvasive, nonopioid therapy for pain in the rectum, perineum, and genitals.

KW - Amitriptyline

KW - Compounded medication

KW - Genital

KW - Ketamine

KW - Pain

KW - Pelvic

KW - Perineal

KW - Rectal

UR - http://www.scopus.com/inward/record.url?scp=84869761610&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84869761610&partnerID=8YFLogxK

M3 - Article

VL - 15

SP - 485

EP - 488

JO - Pain Physician

JF - Pain Physician

SN - 1533-3159

IS - 6

ER -