eISSN: 2081-2833
ISSN: 2081-0016
Medycyna Paliatywna/Palliative Medicine
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4/2016
vol. 8
 
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abstract:

Analgesic effect of the methadone in low doses in the treatment of resistant neuropathic pain in patient with the oral cavity cancer – a case study

Anna Zasowska-Nowak
,
Aleksandra Ciałkowska-Rysz

Medycyna Paliatywna 2016; 8(4): 186–191
Online publish date: 2017/03/07
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Methadone is an opioid receptor agonist belonging to a third step of the analgesic ladder. Antagonism to NMDA receptors and inhibition of serotonin-norepinephrine reuptake in the central nervous system distinguishes methadone from other strong opioids. Methadone is mainly used as a second-line treatment in strong opioids ineffectiveness and/or its side-effects. Opioid rotation to methadone and its small doses added to other strong opioids are the first-choice procedures in cases of opioid tolerance and opioid-induced hyperalgesia. The case study presents a patient with strong neuropathic pain in the course of the oral cavity cancer, in whom methadone used in a daily dose of 15 mg improved analgesia and resulted in reduction of doses of previously used opioids and coanalgesics. Addition of methadone in small doses to previously used strong opioids can be a therapeutic option in patients with neuropathic pain resistant to standard therapy.
keywords:

methadone, neuropathic pain, coanalgesic, resistant pain
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