Presented at the 2012 AAPM Annual Meeting « Back

Initial Dose Determination of Human Chorionic Gonadotropin for Intractable Pain

Forest S. Tennant, MD DrPH, veractinc@msn.com, Veract Intractable Pain Clinic, West Covina, California

Introduction/Statement of Problem: Animal studies indicate that Human Chorionic Gonadotropin (HCG) has neural regenerative potential.1,2 Clinical trials in a small number of intractable pain patients indicate that HCG may ameliorate pain, reduce opioid dosages, and produce pain free hours. A starting dosage is needed to initiate additional studies. Materials: Subjects were 22 adult central, intractable pain patients who had been maintained on daily opioids for over 2 years and who claimed constant pain and had failed multiple peripheral pain treatments. Patients were started on 125 units per milliliter of HCG given three times a week by sublingual drops. Over a 3-month period patients were instructed to progressively increase frequency and dosage until they required a lesser opioid dosage, perceived less pain, and experienced increased energy. This protocol was approved by the facilities Institutional Review Board. Results: Of the 22 subjects, 16 (72.7%) reached the three end points and reported a decrease in opioid dosage, less pain, and more energy. The effective, minimal sublingual dosage was 250 units a day (1750 units a week). The minimal time to achieve the three end points was two weeks. Conclusions: Central pain treatment agents that permanently reduce pain and lower the requirement for opioids are needed. This trial of HCG provides a starting dose for HCG from which to titrate upward and determine if HCG may be effective. References: 1). Patil AA, Nagaraj MP. The effect of human chorionic gonadotropin (HCG) on functional recovery of spinal cord sectioned rats. ACTA Neurochir 1983;69:205-218. 2)Lei ZM, Rao CV. Neural actions of luteinizing hormone and human chorionic gonadotropin. Seminar Reprod Med 2001;19:103-109.

Funding: None