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We often use tricyclic antidepressants. These are good to modulate central recognition of pain, which is associated with serotonin and norepinephrine pathways in the brainstem. They don't get rid of the pain, but if you imagine pain as a radio, they turn the volume down. The benzodiazepines I use in my practice are Ativan® and Valium®. We sometimes use those in patients who have PFD in addition to IC. For spasm of the pelvic floor muscles, use of a striated muscle relaxant like Valium or Ativan will often decrease the spasms. DMSO deserves mention. We are using it less often. In some cases, patients have had a hydrodistention and are miserable. DMSO is given by catheter into the bladder. I know many people have had bad experiences with it. I think that is because the beneficial effects of DMSO will not kick in until around the 5th treatment. It will often make symptoms worse for the first week or two. DMSO causes the mast cells to "dump" the histamine. Eventually you will deplete the mast cells of histamine. This is one of the ways that DMSO works.Get a sneak peek of the all-new AOL.com.

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