Pain Medications for Palliative Care
One way to use opioids while minimizing side effects is to combine them with the broad category of adjuvant analgesics, or "helper medications."
In addition to opioids, there are a number of other helper medications that palliative care specialists use to help control pain. They include:
- Non-steroidal anti-inflammatory drugs (NSAIDS)
- Tricyclic antidepressant medications
- Serotonin and norepinephrine reuptake inhibitor antidepressant medications (SNRIs)
- Anticonvulsant medications
These drugs are particularly helpful for people who are experiencing bone or nerve pain.
There are many causes for bone pain in life-threatening illness, including cancer metastases to the bone and compression of bones in the spine from degenerative bone disease or damage from long-term use of steroids to treat a condition like lung disease.
Using anti-inflammatory adjuvants -- even something as simple as ibuprofen, or something stronger such as a corticosteroid -- can lessen bone pain.
Nerve pain, or "neuropathic" pain occurs when one or more nerves is injured or damaged. It can develop as a result of long-term chemotherapy or cancer itself, trauma, or other medical disorders.
AIDS, diabetes, and shingles are examples of diseases often associated with neuropathic pain.
Tricyclic antidepressants and anti-seizure medications can each lessen nerve pain because they change the way pain sensations travel to the brain.
You may have to try several different medications, or different combinations of medications, to find the ones that are right for you or your loved one. A good palliative care team can help to identify the most effective drugs and minimize side effects.