Using methadone to treat opioid-induced hyperalgesia and refractory pain

Authors

  • David J. Axelrod, MD, JD
  • Barbara Reville, MS, CRNP

DOI:

https://doi.org/10.5055/jom.2007.0048

Keywords:

opioid-induced hyperalgesia, methadone, opioid rotation, opioid tolerance

Abstract

A patient was treated for several years with high doses of opioids for malignant pain. During a recent hospitalization, the patient’s pain remained uncontrolled despite escalating doses of various opioids. We suspected that this patient suffered from the clinical phenomenon of opioid-induced hyperalgesia (OIH). The patient was then rotated from her other opioids to methadone, and her pain was adequately controlled within several days. Methadone, because of its NMDA antagonist properties, offers an effective treatment for OIH. The use of methadone for analgesia is complex and should be undertaken only by practitioners who have appropriate experience.

Author Biographies

David J. Axelrod, MD, JD

Instructor of Medicine, CoMedical Director of Palliative Care Service, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.

Barbara Reville, MS, CRNP

Assistant Director, Palliative Care Service, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.

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Published

03/01/2007

How to Cite

Axelrod, MD, JD, D. J., and B. Reville, MS, CRNP. “Using Methadone to Treat Opioid-Induced Hyperalgesia and Refractory Pain”. Journal of Opioid Management, vol. 3, no. 2, Mar. 2007, pp. 113-4, doi:10.5055/jom.2007.0048.

Issue

Section

Case Studies