From the Guidelines
For immediate relief from acute pain or severe anxiety, it is recommended to first try over-the-counter options like acetaminophen (Tylenol) at 325-650mg every 4-6 hours or ibuprofen (Advil, Motrin) at 200-400mg every 4-6 hours, as well as nonpharmacologic therapies such as deep breathing exercises or progressive muscle relaxation. According to the CDC clinical practice guideline for prescribing opioids for pain - United States, 2022 1, opioids are not recommended as first-line therapy for many common acute pain conditions due to equivalent or lesser effectiveness for pain relief compared with NSAIDs and risks for long-term opioid use.
For acute pain, the guideline suggests maximizing the use of nonopioid pharmacologic and nonpharmacologic therapies as appropriate for the specific condition. When opioids are necessary, immediate-release opioids should be prescribed at the lowest effective dose and for no longer than the expected duration of pain severe enough to require opioids.
Some key points to consider for immediate relief include:
- Using nonopioid medications as the first line of treatment for acute pain conditions such as low back pain, neck pain, and headaches, including episodic migraine 1.
- Implementing nonpharmacologic therapies like ice, heat, elevation, rest, immobilization, or exercise as appropriate for the specific condition.
- For severe anxiety, techniques like deep breathing exercises and progressive muscle relaxation can provide quick relief by activating the parasympathetic nervous system.
- If symptoms persist or worsen, seeking medical attention promptly is crucial, as prescription medications may be necessary, but these should be used under proper medical guidance due to potential side effects and risk of dependence.
It's essential to note that patient education and discussion before starting any therapy are critical, ensuring that patients are aware of expected benefits, common risks, serious risks, and alternatives to any prescribed medication 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Immediate Relief Options
For immediate relief from acute pain or severe anxiety, several options can be considered:
- Pregabalin: This medication has been shown to be effective in treating generalized anxiety disorder (GAD) and neuropathic pain 2, 3.
- Benzodiazepines: These medications can provide immediate relief for anxiety symptoms, but their use should be carefully considered due to the risk of dependence and withdrawal 4, 3.
- Naproxen: This nonsteroidal anti-inflammatory drug (NSAID) can be used to treat pain and inflammation, and it may interact synergistically with gabapentin or pregabalin to produce antihyperalgesia 5.
Important Considerations
When seeking immediate relief, it is essential to consider the potential risks and benefits of each option:
- Pregabalin can cause adverse events, such as myoclonus, especially in patients with impaired renal function 6.
- Benzodiazepines can be difficult to discontinue, and cognitive-behavioral therapy may be necessary to aid in their discontinuation 4.
- Naproxen can cause gastrointestinal side effects and should be used with caution in patients with a history of gastrointestinal problems.
Treatment Efficacy
The efficacy of these options can vary depending on the individual and the specific condition being treated:
- Pregabalin has been shown to be effective in treating both psychic and somatic symptoms of anxiety 3.
- Benzodiazepines can provide significant improvement in both psychic and somatic anxiety factors, but their efficacy may be limited to certain symptoms 3.
- The combination of gabapentin or pregabalin with naproxen may offer therapeutic advantages for the treatment of persistent inflammatory pain 5.