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Several treatment modalities are available within the field of neuropathic pain and neuropathy.


Drs N. Groven and his colleagues from Norway presented a poster at the EFIC in 2017 in Copenhagen, were they explored the peripheral inflammatory character of fibromyalgia. We often recommend palmitoylethanolamide for the treatment of fibromyalgia. This is a supplement based on an endogenous molecule inhibiting inflammation (PeaPlex, Glialia). Fibromyalgia (FM) patients often experience symptoms […]

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Topical TV-45070 8% ointment in herpes zoster pain not effective

Teva Pharmaceutical Industries Ltd. at the end of June 2017 disclosed the results of a Phase II study analysing topical TV-45070 4% and 8% oil in patients with post-herpetic neuralgia (PHN). The ointment treatment (twice a day) did not reduce the primary endpoint, pain measured via the NRS, at week four compared to placebo. However, there were […]

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What to be aware of in PEA: Pure PEA is not always Pure PEA, PEA-opt not always optimum PEA

More and more PEA preparations available. In pots, in blisters, in boxes. What about it? Which one should you choose? Most producers say a lot, for example, that they have the best absorbable PEA, that they are the only ones with ‘GMP PEA’, that they have premium Italian quality and so on. It gets crazier […]

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MicroPEA: an essential component of modern PEA formulations!

MicroPEA is the content of special patented PEA formulations. Only these formulations have a long trackrecord of safety and efficacy.

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Rheumatism, Bechterew disease, mast cells and palmitoylethanolamide

Bechterew is a rheumatic disorder based on chronic inflammation. Since some years the treatment with the natural painkiller and anti-inflammation compound palmitoylethnanolamide in its new formulations containing micro-PEA gives new hope.

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Prostate, chronic pain and treatment with palmitoylethanolamide

Prostate Pains can be treated with the natural anti-inflammatory compound palmitoylethanolamide (PEA). We prefer PEA formulations containing micro-PEA (m-PEA, um-PEA and PEA-opt) as in Normast, PeaPure and PeaPlex.

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Treat burning and painful vagina with natural substance PEA

Vaginal pain, vaginal burning! This is quite common, more so than we think. Specifically among women older than 45 years of age. Many women don’t speak about it, but they do suffer from it. In case of vaginal pain, pain during intercourse or vaginal burning, it is obvious that the doctor or gynecologist needs to […]

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Amputation pain, phantom limb pain and treatment with palmitoylethanolamide

Post-amputation pain is a serious and difficult to treat pain, also referred to as phantom pain. Phantom pain can occur in the arms, legs, hand and feet after amputation, but also in cases of breast amputation related to cancer. Palmitoylethanolamide (PEA) is a natural and body’s own substance that has a pain relieving and anti-inflammatory […]

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MS spasms and pain treatment with body’s own substance palmitoylethanolamide

Palmitoylethanolamide is a new and promising treatment against pain and inflammation. It’s available as a supplement without prescription. PeaPure is a supplement in its purest form. Patients that suffer form MS pains and spasms can get some relief from this substance. In Italy, many neurologists are using this substance and both patients as neurologist are […]

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Endometriosis, menstruation pains and treatment with palmitoylethanolamide

Seven out of 10 menstruating women suffer from abdominal and menstruation pain. The medical term for abdominal pain during menstruation is dysmenorrhea. The so-called primary abdominal pain arises due to the ovulation, which is called primary dysmenorrhea. One of the most common causes of secondary dysmenorrhea is endometriosis. Over 1 out of 10 women suffers […]

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Study supports the significance of palmitoylethanolamide for endometriosis pain

A new study among 24 women with severe menstrual pains due to endometriosis and pain during intercourse, supports the use of palmitoylethanolamide (PEA as in PeaPure). The women experienced a clear decrease in pain, were able to take less pain medicine and experienced less pain during intercourse. The recommended dose is 400mg three times a […]

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Natural treatment of Parkinson with body’s own palmitoylethanolamide

The role of palmitoylethanolamide in Parkinson.

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Palmitoylethanolamide, PEA: key items presented

In the following sequence of presentations we bring to you the essence of knowledge around the body-own compound and supplement palmitoylethanolamide! We start with the general introduction, an overview of palmitoylethanolamide, an endogenous cellular protectant in plants, invertebrates, vertebrates and humans, tested extensively since 1970 and widely available as food supplement. Its main action is […]

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Welcome to our Institute and Website!

neuron.jpgWelcome to our Institute for neuropathy and neuropathic pain, and our Website. We gathered here for you many articles in the field of neuropathy and neuropathic pain. In our centre we are specialised in treating patients suffering from neuropathic pain and neuropathy following an Integrated Medicine concept. Part of our activities are within the field of consultation. We assist pharmaceutical companies in R&D strategies related to finding new drugs to treat neuropathic pain and neuropathy. 

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New treatment options neuropathic pain urgently needed

More and more randomized, double-blind, placebo-controlled trials on neuropathic pain treatment are published, and it seems there is a surge! Will this help the patient? Some top pain experts analysed one hundred and seventy-four studies, a twothird increase in published randomised, placebo-controlled trials in the last 5 years. What did they find out?

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Mast cells, gingivitis and palmitoylethanolamide

Gingivitis is not nice. Redness and pain of the gums and bad breath. The cause of gingivitis is an inflammation of the gingiva, or of the gums. It is found in well over 60% (!) of adults over age 45 or even nearly 100%, according to some dentists. Inflammation of the gums is usually the result of poor dental hygiene. Sadly enough it creates a second, more serious problem, periodontal disease. Unless corrected this usually poses a real thread for both tooth and jawbone. Mast cells can be found in normal gingivae as well as in acute necrotizing gingivitis, chronic marginal gingivitis,andand pregnancy gingivitis, and these cels have been identified already more than half a century ago.

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Integrated Medicine concept for the treatment of neuropathic pain

Research over the last few decades has shown an increased use of complementary and alternative therapies (CAM) and an integration of aspects of CAM into mainstream medical treatment, health care organisations and insurance plans.  It has been shown that the process of care may be as important as the outcomes of treatment, which may explain in part the relatively large popularity of CAM for many patients on a world wide base. (Muir Gray JA. Evidence-Based Healthcare. How to Make Health Policy and Management Decisions. 2. London: Churchill Livingstone; 2001) 

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Amitriptyline as good as pregabalin for painful diabetic Neuropathy

Amitriptyline as good as pregabalin for painful diabetic neuropathy says a review ariticle on Diabetes in, dated March 23, 2010. This is based on the results of a head to head comparison of both drugs in a group of 41 patients. The study had some methodological flaws, but the results are in line with our expectations and experiences. Both drugs have similar efficacy, but amitriptyline, if dosed higher up (>25 mg an) has more side- effects.

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Palmitoylethanolamide (PEA) versus NSAID in the treatment of TMJD pain

In a head to head comparison study the Italian research group from the Department of Orthodontics, of the  School of Dentistry, at the University of Bologna, could demonstrate that treatment with the natural analgesic compound palmitoylethalonamide (available under the brandnames Normast®  or PeaPure® ) was superior over the treatment with a classical NSAID in temporomandibular joint disorder (TMJD), or Costen syndrome.

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Palmitoylethanolamide (PEA) combined with pregabalin in neuropathic pain

Palmitoylethanolamin (Normast®;PeaPure®) is a endogenous lipid with analgesic and anti-inflammatory properties. In a study were 30 patients were entered, suffering from diabetic neuropathic pain and post-herpetic pain, palmitoylethanolamide was combined with pregabalin in the treatment of neuropathic pain.

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Pharmacotherapy of painful neuropathy

In the journal JAMA, October 2009, was a description of a patient with diabetes mellitus and much discomfort from neuropathy. The doctor described the case, showed a list of drugs to see the usefulness of these values. Here on this table we see a number of recent rfindings and the relative strength of various painkillers for neuropathic pain. In this paper a clear message: Lyrica and Cymbalta are no better than older and cheaper drugs, which may be even better!

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Acupuncture recommended by anesthesiologists

In April 2010 a new guideline was issued on the treatment of chronic pain: Practice Guidelines for Chronic Pain Management: An Updated Report by the American Society of Anesthesiologists Task Force on Chronic Pain Management and the American Society of Regional Anesthesia and Pain Medicine. 

In this guideline anesthesiologists of name and fame gathered and analysed all approaches to chronic pain. For acupuncture their assessment was:  

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Palmitoylethanolamide (PEA) at the 3rd European Congress for Integrated Medicine

A presentation of how to treat neuropathic pain in elderly and treatment refractory neuropathic pain patients prescribing the food for medical purposes and our own body-own compound palmitoylethanolamide (Normast®  and PeaPure® ): a presentation in Berlin at the 3rd European Congress for Integrated Medicine by Jan M. Keppel Hesselink, MD, PhD

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Pharmacologic Treatment of Central Post-Stroke Pain

Pharmacologic Treatment of Central Post-Stroke Pain By:  A. Frese, I.W. Husstedt, E.B. Ringelstein, and S. Evers:  ClinJ Pain 2006;22:252–260: 

Treatment Recommendation for CPSP Based on Evidence Level

Short term pain control:
Lidocaine IV 5 mg/kg over 5 minutes

Propofol IV (Gaba-ergic) 0.3 mg/kg per hour  

Oral treatment:
Drugs of first choice(based on controlled trials):  

amitriptyline(anti-depressant) at least 75 mg per day

lamotrigine(glutamatergic) (at least 200mg per day

Drugs of second choice(based on open studies and experts’ opinion):

Mexiletineupto10 mg/kg per day

Fluvoxamin up to 125mg per day

Gabapentinat least 1200mg per day

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Cancer and neuropathic pain

You are definitely familiar with symptoms as numbing, tingling, or prickling sensatiob,  after you have hit your funny bone, or your foot falls asleep. But for cancer patients, these sensations can be symptoms of either cancer itself, or, more often, a serious side effect of cancer therapy called neuropathy (injury to the nerves).

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Trigeminus neuralgia treated with Gamma Knife surgery

Trigeminus neuralgia is difficult to treat. For those patients were medication such as carbamazepin is not helpful, the neurosurgeon can treat with the so called Gamma Knife…. 

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Beveiligd: Normast e PeaPure: informazioni palmitoilethanolamide

Er is geen samenvatting, omdat dit een beveiligd bericht is.

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Normast and PeaPure: questions and answers

What exactly is Normast  and PeaPure?

In this page many clinical and patient driven questions will be discussed. This page is under construction. A website has been created for palmitoylethanolamide related science only.

Normast and PeaPure are brandnames for supplements containing a body own molecule, palmitoylethanolamide, against pain and inflammation.  

Normast however contains magnesium stearate, a alien fat for our body, undigestable and an excipient doctors recommend to avoid.

All scientific information is discussed in this review.

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Multimodal therapy in neuropathic pain: 2 is more than 1!

The famous Dutch surgeon Noordenbos wrote in 1959: "One-one synaptic transmission must be the exception rather than the rule in the nervous system. Any nerve cell located in the anterior horn. . . could hardly be expected to synapse at higher level with one such similar cell only. It will probably send ramifications to many other locations, and in turn be acted upon by the ramifications of many other cells. . . Far from being a continuous chain of short neurons, these fibres must constitute links in an extremely complicated nerve net in which, within limits, everything synapses more or less with everything else." It is clear that half a century later our therapy of pain is based on these deep insights of Noordenbos, and multimodal therapy is now the hallmark of how to treat neuropathic pain. This is because it is difficult to treat neuropathic pain with one drug only. In our centre we nearly always prescribe two or more oral drugs and mostly also topical creams and supplements together to get the patients out of the red zone of discomfort.

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Neuropathic low blood pressure: Droxidopa

Patients suffering from small fibre neuropathy sometimes also suffer from difficult to treat low bloodpressure. In the Orient there is a registered drug for this dindication: L-DOPS (L-threo-dihydroxyphenylserine; Droxidopa; SM-5688). Droxidopa is a synthetic amino acid precursor which acts as a prodrug to the neurotransmitters norepinephrine (noradrenaline) and epinephrine (adrenaline). Unlike norepinephrine and epinephrine themselves, L-DOPS is capable of crossing the protective blood-brain barrier (BBB).

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