The Workers Compensation Board in New York crafted these guidelines to aid doctors, podiatrists, and healthcare experts in administering suitable treatment involving Norepinephrine Reuptake Inhibitor Antidepressants for CRPS.
These guidelines aim to help healthcare professionals decide on the right level of care for patients dealing with Complex Regional Pain
It’s crucial to understand that these guidelines don’t replace the expertise and experience of healthcare providers. The final decision about care should be a collaborative one, made by the patient in consultation with their healthcare provider.
Norepinephrine Reuptake Inhibitor Anti-depressants for CRPS
Using norepinephrine reuptake inhibitor antidepressants, particularly tricyclic antidepressants, is recommended for treating CRPS (Complex Regional Pain Syndrome) and chronic pain that hasn’t responded adequately to exercises, aerobic activities, and NSAIDs.
For individuals experiencing persistent pain and minimal sleep disruption, these antidepressants can be especially helpful, allowing for nightly dosing of a mildly sedating tricyclic antidepressant, particularly in cases of dysthymia.
In terms of frequency, dose, and duration, starting with a low dose of Amitriptyline (25mg QHS, increased by 25mg each week) at night is suggested. The dosage can be gradually raised until reaching a sub-maximal or maximal dose, observing for both positive effects and potential side effects. Generally, lower doses, such as Amitriptyline 25 to 75mg per day, are recommended to avoid unwanted effects, with regular blood level monitoring, as larger doses don’t necessarily lead to enhanced pain relief.
The duration of treatment for CRPS may vary, and while the condition often improves or resolves on its own, extended treatment may be unnecessary for most individuals. Imipramine, being less sedating, could be a preferable alternative to Amitriptyline if daytime sedation carries over. However, Amitriptyline is the initial drug of choice, especially when sleep initiation is a concern.
What our office can do if you have workers compensation injuries
We’ve got the expertise to assist you with your workers’ compensation injuries. We empathize with the challenges you’re facing and are committed to addressing your medical needs while adhering to the guidelines established by the New York State Workers Compensation Board.
Recognizing the significance of your workers’ compensation cases, we’re here to guide you through the complexities of dealing with both the workers’ compensation insurance company and your employer.
We understand that this period can be stressful for you and your family. If you’re interested in scheduling an appointment, please get in touch with us. We are dedicated to making the process as smooth as possible for you.
