August 08, 2004

Topical anesthetics help with depot injections

Psychiatr Serv. 2004 Aug;55(8):940-1.

Use of topical application of lidocaine-prilocaine cream to reduce
injection-site pain of depot antipsychotics.

Bloch Y, Levkovitz Y, Atshuler A, Dvoretzki V, Fenning S, Ratzoni G

This article explores a new way to help make giving long term injectable (depot) medicines less painful. Long term medications are useful because they help to insure adherence to a medication program in that a patient only has to come to a clinic one time every two weeks or every month to receive a shot and does not have to take pills every day. As more of the newer antipsychotics are being prepared in this fashion (i.e. long acting risperidone aka Risperdal Consta, but the other drugs are being developed in long term preparations) this method of dispensing medication is likely to increase. However, this leads to many injections over the course of the year and patients often complain of and can be fearful of the pain associated with the injection. The technique in this article involves putting on an anesthetic (numbing) cream one hour prior to receiving the injection. Fifteen patients were selected and received either the cream or a moisturizer (placebo) on one injection and then received the other on their next injection. In both cases, neither the nurse who gave the shot nor the patient knew what kind of cream they received. Patients were then asked to rate the pain they experienced with the injection by pointing to visual or picture representation of pain.

As what was expected, the patients who received the anesthetic cream had significantly less pain reported compared to those who received simply a moisturizing cream. The authors note that one drawback of this type of pain relief is that it takes an hour prior to the injection for the cream to work. However, patients could be given the cream to take at home or would have to spend an extra hour in the clinic to wait for the medicine to work. Either way, for patients currently on depot medications, like Haldol Decanoate, Prolixin Decanoate or Risperdal Consta this may be something to ask for before receiving what can be a painful injection.

link to the article on pubmed

Author: Jacob Ballon


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