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Published on: July 16, 2014
Methadone in the treatment of neuropathic pain
Bruno Gagnon1, Abdulaziz Almahrezi, Gil Schreier
1Royal Victoria Hospital, Montreal, Canada. bruno.gagnon@clinepi.mcgill.ca
Background:
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. 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.
Results:
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.
Conclusion:
Methadone at relatively low doses seems to be useful in the treatment of neuropathic pain.
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