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Prialt in a pain pump

Neck of Steel CindyNNeck of Steel Cindy Posts: 1,065
edited 06/11/2012 - 7:50 AM in Pain Management
I had my consult with the pain pump doctor today, and he is recommending a pain pump using prialt as the medication, at least to start with. He feels like in my situation, this would give me the best relief for all the neuropathic pain I have. Said the trial for prialt is only 4 hours, and it is immediate relief if it helps.

I have read some horror stories on the net about Prialt, mostly that it makes people psychotic. We discussed this today, and he said the other medications scare him more than Prialt. With prialt, it can be stopped immediately with no side effects. It is not an opiod. At first report of any adverse reaction, the patient is to come right in and the medication would be stopped, no appointment necessary for any of his pain pump patients. He said the mild chance of a psychosis reaction, there are basically NO other side effects of this medication. And, if all I used in the pump is prialt, it only has to be filled every 6 months. Amazing.

Contrast that with morphine and baclofen in the pump, which is something that I may need to cover my other pain and spasticity. My doctor told me there are many risks with those medications. If you run out, it could be immediately fatal, especially with the baclofen. If an error was made in the amount administered, morphine could go straight to your brain and kill you. He said these things don't happen frequently, and he has never killed anyone by running out of medicine or administering the correct dose, but his point was that the risk was higher with these medicines than something going wrong with the Prialt.

So now I'm seriously considering the Prialt. I haven't heard it discussed on these boards. Does anyone have experience with this med in a pain pump?

Surviving chronic pain one day at a time, praying for a reprieve because living another 40 years like this doesn't sound too fun!


  • Is it something you can take orally before you try it in the pump? Are you going to need opiate medication seperately?

    These are just things I'm curious about.
  • Very best of luck to you with your trial. I do hope and pray your experiance with your pump (if you move forward with it)is as good as mine has been.

    Did your Doctor say what he would try if the Prialt did not work for you? What would be his second choice? Like you, all I know about Prialt is what I have read about it.

    It seems he just does "one dose" trials. Would he give you a longer trial on some other medication if the Prialt does not work?

    I do hope he is correct and you feel instant relief. That would be wonderful.

    Please keep us updated as you move forward on your journey for pain relief.

    Cheers :H
    Patsy W

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  • I agree with Pat and what if Prialt doesn't work? Would he try another med or has he ever had to switch anyone else to another medication due to side effects? Best wishes with your trial. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Prialt apparently has an immediate effect, which is why it is only a 4 hour trial. It can only be administered intrathecally (pain pump). The doctor told me that I will know within an hour if this is going to work for me or not. I questioned him because as we all know, pain has varying levels, and what if the day I am doing the trial, the nerve pain is not as bad? A 4 hour trial just doesn't sound long enough to me.

    He said that to do a trial of the other medications, it will be an overnight stay, and will be done on a different day. Prialt will target the neuropathic pain. The other medications will take care of the spasticity and neck pain. So I would actually be doing two different trials, if I choose to go forward.

    According to my doctor, if I solely use Prialt in a pain pump, it will only need to be filled every 6 months. If I add other medications to the mix, it changes the efficacy of it, and I will need refills possibly even monthly, depending on what meds and dosages are involved. I am certain that the Prialt won't take care of all my pain and I will need other meds with it. So do I just take stronger oral medications and forget the pain pump? Lots of decisions to make, and i don't do that well.

    Surviving chronic pain one day at a time, praying for a reprieve because living another 40 years like this doesn't sound too fun!
  • really negative stuff about Prialt from others who have given it a try at the recommendation of their PM doctors. I would really do much in the way of searches on the internet and on yahoo in the pumpster's group since they seem to have the most information regarding prialt and it's use in the pump. I think that I have only read one positive story in my two years there as a member.
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  • some negative stuff also about Prialt. But I have also read success stories using it.

    Because Prialt has not been approved very long, it is fairly new on the market, not a lot of Doctors are using it yet. In my state only one Doctor was using it last year.

    As more and more Doctors begin using it I am sure we will hear of more success with it. As Neck of Steel said, it is not a narcotic so it can be stopped instantly with no ill effects. From what I have read, as soon as any adverse effects start, if the Doctor backs down the dose the side effects disappear.

    I also just read that there is a pill now in clinical trials that works the same as Prialt does to reduce pain and if a success it will be on the market sometime this year. It is not a narcotic either.

    The reason I am so interested in this question is because I have a pain pump.

    Best of luck in deciding what to do. This is a tough decision to make.

    Patsy W
  • I just saw my PCP yesterday, and he was very negative about any type of pain pump. He states that through his 30 years of being a doctor, he has not had even one patient have long term success with pain pumps. He said that yes, the patients get relief in the beginning, but that eventually they have the pump removed for one reason or another. Geez, this is all so confusing.

    I will keep researching though. My pcp is not a pain doc, and I just have to believe in the doctors who do this all day long. Surely they wouldn't be recommending something if it were not a good thing.
    Surviving chronic pain one day at a time, praying for a reprieve because living another 40 years like this doesn't sound too fun!
  • I thinking of trying this should I be? And what about withdrawal from the drug I use now? Or should I take the pump out??? Geeez LivIng with pain for ten years not one good day it's a P A I N !
  • 4 hour trial? Is he nuts. Once the pump is put in for the trial what does it mater to him if you have the trial for days? Nobody will know if its helping within 4 hours. If a person is going to get this implanted in there body for life you should be given enough time to do the trial for as many days as posible.

    There should be no diference how the trial is done i dont care what meds they use in the pump. As you said cindy pain is diferent every day and what if you dont have a flare up on the day of the 4 hour trial? Not to mention while they tap that line in to the spinal fluid they give you medication during the procedure that will already make the pain subside which will cause a false trial because you will never know within those 4 hours if the releif you have is from the pump or the procedure medications"

    Unless you can have a normal trial and use the pump at home as a trial like it should be i would tell the dr stick it up his ass for the 4 hours. 4 hour trial in no way can be conclusive trial to be able to make a solid decision on it and they should know this.

    I would want to know how it makes me feel for at least a week if not longer but i know trial is usualy just a week. Been there done that. And i would have to see if it makes me get sick during that week or is it actualy helping my pain and i am ok with it.

    4 hour will just test the unit make sure its working its not testing how the patient feels and what results they will have day in day out. Was this dr droped on his head as a child? Common sense is just not very common these days.
    Flexicore ADR 2004 resulting nerve damage l4l5 Fusion 2006 same level, 2009 hardware removal with lami !
    2012 scs implant ,
  • Oops i just noticed post is from january. Did you have it done ?
    Flexicore ADR 2004 resulting nerve damage l4l5 Fusion 2006 same level, 2009 hardware removal with lami !
    2012 scs implant ,
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