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How to Prepare for Your First Calmare Treatment

Getting ready for your first Calmare appointment is easy. A few things will make your experience smoother and your treatment more effective.

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Step 1: Review the interfering medications list with your doctor

Some medications can slow down or prevent Scrambler Therapy from working optimally. For the best results, we usually advise that you and your prescribing physician create a plan to safely taper off any listed medication, with your last dose 72 hours or more before your first visit. Stopping for a longer period (for example, 2 full weeks) is even better, so any lingering withdrawal symptoms have passed. If you have any concerns about tapering, please discuss them with our office and your prescribing physician.

A printable version of this medication list is coming soon so you can share it with your prescribing physician.

Common anticonvulsant and anti-seizure medications that may interfere

  • Acetazolamide (Diamox)
  • Adinazolam (Deracyn)
  • Alprazolam (Xanax)
  • Amitriptyline (Elavil)
  • Brivaracetam (Briviact)
  • Carbamazepine (Tegretol, Carbatrol, Epitol, Equetro)
  • Cenobamate (Xcopri, Ontozry)
  • Clobazam (Onfi, Frizium)
  • Clonazepam (Klonopin, Rivotril, Clonpam)
  • Diazepam (Valium)
  • Eslicarbazepine (Aptiom)
  • Ethosuximide (Zarontin)
  • Ethotoin (Peganone)
  • Etiracetam
  • Everolimus (Afinitor, Votubia)
  • Felbamate (Felbatol)
  • Fosphenytoin (Cerebyx)
  • Gabapentin (Neurontin, Gralise, Fanatrex, Gabarone, Horizant)
  • Lacosamide (Vimpat)
  • Lamotrigine (Lamictal)
  • Levetiracetam (Keppra)
  • Lorazepam (Ativan)
  • Mesuximide (Petinutin, Celontin)
  • Nortriptyline (Aventyl, Pamelor)
  • Oxcarbazepine (Trileptal, Oxtellar)
  • Phenytoin (Dilantin, Epanutin)
  • Piracetam
  • Pregabalin (Lyrica)
  • Progabide
  • Primidone (Mysoline)
  • Rufinamide (Banzel, Inovelon)
  • Stiripentol (Diacomit)
  • Tiagabine (Gabitril)
  • Topiramate (Topamax, Trokendi, Topiragen)
  • Valproic Acid (Convulex, Depakote, Depakene, Epilim)
  • Vigabatrin (Sabril, Vigpoder)
  • Zonisamide (Zonegran)

Other interfering medications

  • Ketamine: recommend discontinuation 2 to 3 months before your first visit for optimal response
  • THC: can impair effectiveness of treatment and decrease duration of relief afterward
  • Muscle-relaxant type medications may impede optimal response
  • Some serotonergic antidepressants and anti-anxiety medications may interfere
  • Dextromethorphan (Robitussin, Delsym, and similar cough syrups)
  • Methadone may potentially interfere, similar to ketamine but to a lesser degree

Helpful medications (generally compatible)

  • OTC or prescription antihistamines such as hydroxyzine
  • Prescription steroid anti-inflammatories
  • OTC NSAIDs such as ibuprofen or naproxen
  • Low Dose Naltrexone

If you cannot safely stop your medication completely

  • Only two medications have been shown to completely block the Calmare Scrambler's pain relief signals: ketamine and dextromethorphan (the active ingredient in many common cough syrups). If you are taking either of these, your treatment will likely not work.
  • If you experience severe difficulty with sleep, you may pause your taper or step back up a dose, depending on your prescribing physician's recommendation.
  • Having interfering medications in your system usually means treatment will be less effective, and you will likely need more sessions to achieve lasting relief.

Benzodiazepine withdrawal: a critical warning

If you take benzodiazepines (generic names typically ending in "azepam" or "azolam," such as Valium, Xanax, or Klonopin), it is critically important to work closely with your prescribing doctor and taper off slowly. Never stop benzodiazepines cold turkey. Abrupt stopping or tapering too quickly can cause severe and potentially dangerous withdrawal symptoms. Rapid withdrawal can dramatically increase anxiety, depression, and agitation, and is associated with a significantly heightened risk of suicidal thoughts and actions. Taper slowly and strictly according to your prescribing physician's advice, and make sure family and close friends help monitor for any worsening anxiety or depression during the taper so symptoms can be managed properly and safely.

Precautions and contraindications

Your safety is our priority. The device manufacturer lists precautions and contraindications similar to other forms of electrical stimulation. Please review this list and call our office to discuss any concerns:

  • You have a pacemaker or automatic defibrillator
  • You have an implanted device such as a spinal nerve stimulator or implanted drug delivery system
  • You have a history of epilepsy, brain damage, or use of anticonvulsant medications for purposes other than pain control
  • You are restricted from using an MRI device
  • You have a history of, or have recently been treated for, myocardial infarction (heart attack) or ischemic heart disease within the past six months
  • You have a heart stent, aneurysm clip, vena cava clip, or other coronary or vascular stent
  • You have a skull plate (metal implants for orthopedic repair such as pins, plates, and joint replacements are allowed)
  • You have, or believe you may have, severe heart arrhythmia or any equivalent heart disease
  • You are, or could be, nursing or pregnant
  • You have wounds or skin irritation where electrodes need to be placed
  • You have a history of allergic reactions or intolerance to transcutaneous electrical nerve stimulation

What to wear

Wear loose-fitting clothing that allows easy access to the areas experiencing pain or numbness. If you need to change, we have a large handicap-accessible bathroom where you can change into shorts or a loose-fitting top.

A few final tips

  • Arrive well-rested and well-hydrated so your body conducts the treatment signal effectively.
  • Cleanse the skin around the treatment area and along your spine, and remove any lotion or oil. Skip these products in treatment areas for the duration of your plan; if needed, apply lotion shortly after treatment each day so your skin has about 23 hours to absorb it before your next session.
  • Bring a notebook to jot down questions and key points from your consultation.
  • Ask questions and share concerns any time. Open communication makes treatment better.

Have a question before you book?

If you are unsure about a medication or a health condition on this page, call our office and we will talk it through with you.

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