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University of Washington · Psychiatry and Behavioral Sciences
Active 1999–2026
Dr. Daniel Krashin is an Assistant Professor at the University of Washington working in Psychiatry and Pain Medicine. He works with both inpatient and outpatient pain patients, clinics, and hospital staff to collaborate on treatment of patients, and also works on improving systems of care delivery to benefit patients and populations across the continuum of care. Dr. Krashin has extensive experience working with underserved and vulnerable populations including the chronically mentally ill, recent immigrants, and HIV patients in the treatment of both psychiatric illness and chronic pain. He has lectured extensively and authored a number of publications in the areas of pain management, comorbid pain and psychiatric disorders, substance abuse in the setting of pain treatment, and pharmacology of opioids and other pain relieving medications. He works closely with residents and pain fellows and participates in teaching the future generations of psychiatrists, anesthesiologists, and pain providers. He is board certified in both Psychiatry and Pain Medicine.
Cognitive Dysfunction in Migraine: Underlying Mechanisms and Clinical Implications
Current Pain and Headache Reports · 2026-04-10
PM&R · 2025-02-04 · 1 citations
BACKGROUND: Individual treatments for chronic low back pain (CLBP) have small magnitude effects. Combining different types of treatments may produce larger effects. OBJECTIVE: To (1) assess feasibility of conducting a factorial randomized controlled trial of these treatments; and (2) estimate individual and combined treatment effects of (a) lumbar radiofrequency ablation (LRFA) of the dorsal ramus medial branch nerves (vs. a simulated LRFA control procedure) and (b) Activity Tracker-Informed Video-Enabled Cognitive Behavioral Therapy program for CLBP (AcTIVE-CBT) (vs. an educational control treatment) on back-related disability at 3 months post-randomization. METHODS: Participants (n = 13) were randomized in a 1:1:1:1 ratio in a 2 × 2 factorial randomized controlled trial. Feasibility goals included an enrollment proportion ≥ 30%, a randomization proportion ≥ 80%, and a ≥ 80% proportion of randomized participants completing the 3-month Roland-Morris Disability Questionnaire (RMDQ) primary outcome end point. An intent-to-treat analysis was used. RESULTS: The enrollment proportion was 62%, the randomization proportion was 81%, and all randomized participants completed the primary outcome. Though not statistically significant, there was a beneficial, moderate-magnitude effect of LRFA versus control on 3-month RMDQ (-3.25 RMDQ points [95% confidence interval [CI], -10.18 to 3.67]). There was a significant, beneficial, large-magnitude effect of AcTIVE-CBT versus control (-6.29 [95% CI, -10.97 to -1.60]). Though not statistically significant, there was a beneficial, large effect of LRFA+AcTIVE-CBT versus control (-8.37 [95% CI: -21.47, 4.74]). CONCLUSION: We conclude that it is feasible to conduct a randomized controlled trial combining procedural and behavioral treatments for CLBP. CLINICALTRIALS: gov Registration: https://clinicaltrials.gov/ct2/show/NCT03520387.
Pharmacology and Clinical Relevance of Commonly Used Drugs
2024-01-01
Sedation for Interventional Techniques
2024-01-01
Clinical Journal of Pain · 2023-04-06 · 27 citations
OBJECTIVES: To determine if the frequent use of a combined biofeedback-virtual reality device improves headache-related outcomes in chronic migraine. MATERIALS AND METHODS: In this randomized, controlled pilot study, 50 adults with chronic migraine were randomized to the experimental group (frequent use of a heart rate variability biofeedback-virtual reality device plus standard medical care; n=25) or wait-list control group (standard medical care alone; n=25). The primary outcome was a reduction in mean monthly headache days between groups at 12 weeks. Secondary outcomes included mean change in acute analgesic use frequency, depression, migraine-related disability, stress, insomnia, and catastrophizing between groups at 12 weeks. Tertiary outcomes included change in heart rate variability and device-related user experience measures. RESULTS: A statistically significant reduction in mean monthly headache days between groups was not demonstrated at 12 weeks. However, statistically significant decreases in the mean frequency of total acute analgesic use per month (65% decrease in the experimental group versus 35% decrease in the control group, P <0.01) and depression score (35% decrease in the experimental group versus 0.5% increase in the control group; P <0.05) were shown at 12 weeks. At study completion, more than 50% of participants reported device satisfaction on a 5-level Likert scale. DISCUSSION: Frequent use of a portable biofeedback-virtual reality device was associated with decreases in the frequency of acute analgesic use and in depression in individuals with chronic migraine. This platform holds promise as an add-on treatment for chronic migraine, especially for individuals aiming to decrease acute analgesic use or interested in nonmedication approaches.
medRxiv · 2023-06-05 · 1 citations
Individual treatments for chronic low back pain (CLBP) have small magnitude effects. Combining different types of treatments may produce larger effects. This study used a 2×2 factorial randomized controlled trial (RCT) design to combine procedural and behavioral treatments for CLBP. The study aims were to: (1) assess feasibility of conducting a factorial RCT of these treatments; and (2) estimate individual and combined treatment effects of (a) lumbar radiofrequency ablation (LRFA) of the dorsal ramus medial branch nerves (vs. a simulated LRFA control procedure) and (b) Activity Tracker-Informed Video-Enabled Cognitive Behavioral Therapy program for CLBP (AcTIVE-CBT) (vs. an educational control treatment) on back-related disability at 3 months post-randomization. Participants (n=13) were randomized in a 1:1:1:1 ratio. Feasibility goals included an enrollment proportion ≥30%, a randomization proportion ≥80%, and a ≥80% proportion of randomized participants completing the 3-month Roland-Morris Disability Questionnaire (RMDQ) primary outcome endpoint. An intent-to-treat analysis was used. The enrollment proportion was 62%, the randomization proportion was 81%, and all randomized participants completed the primary outcome. Though not statistically significant, there was a beneficial, moderate-magnitude effect of LRFA vs. control on 3-month RMDQ (-3.25 RMDQ points; 95% CI: -10.18, 3.67). There was a significant, beneficial, large-magnitude effect of AcTIVECBT vs. control (-6.29, 95% CI: -10.97, -1.60). Though not statistically significant, there was a beneficial, large effect of LRFA+AcTIVE-CBT vs. control (-8.37; 95% CI: -21.47, 4.74). We conclude that it is feasible to conduct an RCT combining procedural and behavioral treatments for CLBP.
Neurology · 2022-05-03
To determine if frequent use of a combined biofeedback-virtual reality (VR) device improves outcomes in chronic migraine, including headache days, frequency of acute medication use, migraine-related disability, anxiety, depression, sleep disturbance, and catastrophizing.
Neurology · 2022-05-03
Our objective was to analyze self-reported cognitive dysfunction and related symptoms in migraineurs presenting to a university-based tertiary care headache clinic.
Neurology · 2022-05-03
Describe the characteristics of patients diagnosed with migraine and Benign Paroxysmal Positional Vertigo (BPPV) at University of Washington Medical System.
Fear of Brain Tumor in Patients with Migraine in an Academic Headache Clinic (P9-2.001)
Neurology · 2022-05-03
Our objective was to analyze self-reported fear of brain tumor and related symptoms in migraineurs presenting to a university-based tertiary care headache clinic.
Natalia Murinova
University of Washington
Andrea M. Trescot
Helen W. Karl
Seattle Children's Hospital
Alan D. Kaye
Louisiana State University Health Sciences Center Shreveport
Jane C. Ballantyne
PhdFit ranks faculty by your research interests, methods, and publications — grounded in their actual work, not templates.
Melissa Schorn
Silvie Bělašková
University Hospital Brno
Ami Cuneo
University of Washington