Pain Is Inevitable But Suffering Is Not: Dr Hemant Mehta

‘To anyone living in persistent pain: it is possible to overcome chronic pain. You do not have to learn to live with it or manage it. You can treat it and change it.’  

Recent advances in the medical field have made our lives simpler in the most serious conditions, one such kind of treatment modality is neuroleptic Infusion therapy.  

What is neuroleptic infusion therapy?  

It is an anaesthetic process that involves using a combination of medications that produce dissociative analgesia by causing thalamocortical dissociation in the brain that resets the pain-sensitised nerve fibres and increases the tolerance to pain. It dissociates you from reality and relieves pain and allays anxiety by acting like a tranquilliser.  

How does the therapy work? 

Well, the whole process is an outpatient short-term monitored treatment for a duration of approximately 4-5 days which helps to tide over the acute crises of long-standing pain and in turn reduces the requirement of other medications without an overnight hospital stay. When this combination is given intravenously, it causes complete analgesia without hypnosis and has a smooth onset and rapid recovery. During the therapy, the patient is undisturbed and can listen to the music of their choice and it helps to calm the patient and provide dissociation from surrounding 

Who can be benefitted from the therapy?  

Relieving the patient from pain is half the battle won by the disease. Patients with chronic pain due to widespread metastasis of cancer on multiple painkiller and narcotic medications, but no pain relief. This treatment helps to reduce the dosage of these medications and in turn avert the side effects caused by them. One of such kind is a young mother of 2 children, detected with the spread of breast cancer to the spine with radiating pain to the left leg making her dependent on the walker, she came to us with her only hope to be able to stand independently and with this neuroleptic infusion treatment for over 4 days she went home with a new take on life.  

One of our recent patient was a girl in her mid-thirties from New Zealand who suffered a simple ankle sprain leading to restricted mobility of her left leg and over the time causing something that is called Complex regional pain syndrome, which made her life miserable with no improvement after 4 months of different medications. Many physicians and treating doctors labelled it as a psychiatric complaint, dejected and depressed she flew all the way down after a 15hours journey to us as her only ray of hope. After counselling and multidisciplinary approach, neurolept infusion therapy was given to her for 4 hours daily for 4 days along with a positive feedback therapy and physiotherapy, on day 5 patients left with fewer medications and a joyous smile. This multimodal approach helped her get her life back on track. 

Headache being the most commonest symptom is often ignored but over time can become something grave and seriously hampering one’s ability to live his normal life. We had a young man who suffered from an unknown cause of headache in spite of multiple tests and investigations. He was put on vigorous oral medications for months but showed no improvement. We started him on neurolept infusion therapy and in no time it helped him regain his confidence and get back to work to lead his normal life. 

What are the side effects of this therapy and Who should avoid this therapy? 

In clinical practice, this therapy is considered safe, and in general, side effects are well tolerated, some of them may experience, drowsiness, dizziness, nausea, vomiting , dry mouth and increased frequency of urination. On the other hand pregnant females, people with uncontrolled high blood pressure ,angina, deranged liver enzymes, glaucoma, and Intoxication of alcohol/ other substance abuse should avoid this therapy.  

What is the duration of this therapy and what is the frequency between two procedures for patients?

Average time for each infusion is 4 hours, depending on the severity of symptoms and patient’s response to the therapy, the pain physician decides the number of sessions- it can range from twice or thrice a week to once a week. Requires constant agile monitoring of pain symptoms post procedure where the pain nurse plays an important role in monitoring the patients 24 hours if need arises. 

By changing the interpretation of pain in the brain and reducing the mental agony, the depressive and restrictive attitude, neurolept infusion therapy with mild physiotherapy can help in bringing day to day changes and the patient is encouraged to live a normal life. 

Pain doesn’t wait….Why should you?? 

We at Sir H.N Reliance Foundation Hospital and Research Centre believe in RESPECT FOR LIFE, to promote health and healing with compassion and respect. Our fully equipped pain clinic involves a comprehensive approach to the patient on the first day, diagnosing their disease and medical condition, formulating an individualised treatment plan and if our experts feel the need patients can be advised for neurolept infusion therapy. Pain clinic is versatile with fully equipped technology and modalities, including sonography, fluoroscopy and ablation machines that helps us to carry out procedures in well-equipped procedure room/day care facilities keeping the patient safe. This treatment is beneficial to improve the quality of life, reduce the disabilities, combat the anguish and give your life a new meaning to live with. Pain is inevitable but suffering is not.