Retro Drugs in Addiction Medicine - When "old school" meets "new school"

[Dr. Joel Nathan]

Being am MD for 29 years, I've seen drugs come and go.

Some, like Zomax®, the "wonder pain relieving drug in the early '80s, was taken off the market for producing liver problems. More recently some cox-2 non-steroidal pain relievers were on the chopping block due to safety concerns. You probably are aware of many others.

However, there are drugs that have been used in the past and some how got lost in the shuffle. Some were discontinued due to lack of profitability, some were just seen as having too many side effects and so were not prescribed by as many docs as it could have been prescribed.

I call them "Retro-drugs" - new safe uses for "old school" meds.

This thread will take you through the memory lane of the past and into the future of medication use.

Please add any the are familiar to you.

Joel

[Dr. Joel Nathan]

AMRIX® (Cyclobenzaprine Hydrochloride Extended-Release Capsules) relieves pain due to skeletal muscles spasm of local origin without interfering with muscle function.

It is a spin-off of Flexeril® (Cylcobenzaprine HCl) - this drug is rapid acting and helped muscle aches too, but due to it's rapid action made people drowsy and clouded. Not too good if you're trying to focus during a workout, driving, etc.

The prescribing instructions say to take 15-30mg at dinner. That way one can utilize the med to help sleep but it also continues to work, without decreased alertness, during the day. I prescribe it for the back muscle spasm that is sometimes associated with opiate withdrawal.

Joel

[Dr. Joel Nathan]

Provigil® is FDA approved for narcolepsy, sleep apnea, shift work sleep disorder (having to work at night but needing to be up for a bit in AM) and ideopathic hypersomnia (sleepiness due to unknown cause).

I currently prescribe modafinil for the fatigue associated with fatigue during opiate wirthdrawal Although modafinil is a controlled substance my patients don't crave it. There is no withdrawal. They don't find it an exciting or euphoric drug. If anything, they may feel agitation and I have to discontinue it.

Modafinil increases attention span and focus and can also be used in the gym to improve focus during workouts.

With respect to doses on the above and if it's appropriate for you, please check with your health care provider.

Joel