Abstract
Methadone, being an N-Methyl-D-Aspartate receptor antagonist, may have a potential role in the treatment of neuropathic pain. To evaluate the effect of methadone in the treatment of neuropathic pain and to estimate the possible dose ranges needed for pain control. Methadone was offered as a treatment option to consecutive cancer and noncancer patients with neuropathic pain. Pain intensity was measured by the visual analogue scale (VAS) (0-10 cm where 0 = no pain and 10 = worst possible pain). Mechanical allodynia and paroxysmal (shooting) pain were assessed clinically. All assessments were collected prospectively before treatment and once a stable dose of methadone was reached. A total number of 18 patients met our inclusion criteria. The mean pretreatment VAS +/- SD was 7.7+/-1.5 cm and this dropped significantly to 1.4+/-1.7 cm on a stable dose of methadone (P<0.0001). Nine of 13 patients (70 %) had a complete resolution of mechanical allodynia and all eight patients (100%) with shooting pain reported a complete response. The median stable dose of methadone was 15 mg per day. Methadone at relatively low doses seems to be useful in the treatment of neuropathic pain.
Highlights
Methadone, being an N-Methyl-D-Aspartate receptor antagonist, may have a potential role in the treatment of neuropathic pain
Based on the preceding arguments, we offered methadone to patients with neuropathic pain as an option for treatment and we documented prospectively the clinical response
Patients were included according to the following criteria: presenting with a neuropathic pain syndrome not associated with other types of pain such as bone pain or visceral pain; not receiving strong opioids even though the pain was of sufficient severity to require strong opioids; or already receiving strong opioids but experiencing side effects, preventing further dose escalation and requiring an opioid rotation
Summary
Methadone, being an N-Methyl-D-Aspartate receptor antagonist, may have a potential role in the treatment of neuropathic pain. OBJECTIVES: To evaluate the effect of methadone in the treatment of neuropathic pain and to estimate the possible dose ranges needed for pain control. METHODS: Methadone was offered as a treatment option to consecutive cancer and noncancer patients with neuropathic pain. Mechanical allodynia and paroxysmal (shooting) pain were assessed clinically. All assessments were collected prospectively before treatment and once a stable dose of methadone was reached. The mean pretreatment VAS ± SD was 7.7±1.5 cm and this dropped significantly to 1.4±1.7 cm on a stable dose of methadone (P
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