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Fentanyl

Fentanyl Reactions 1704, p161 - 2 Jun 2018 Opioid dependence: case report A 67-year-old woman developed opioid dependence during treatment with fentanyl for chronic back pain [duration of treatment to reaction onset not stated]. The woman had a history of chronic back pain due to multi- level prolapsed intervertebral discs, fibromyalgia, insomnia and depression. She was receiving fentanyl patch 200µg every 72 hours and clonazepam for the back pain for 12 years. She was referred to the Rheumatology for suspected spondyloarthropathy. However, the rheumatologic work-up was negative. On re-evaluation, she reported that she always had mind-racing, crying, agitation, irritability, insomnia and depression. An examination revealed that she had poor insight, was anxious, depressed and agitated. All her findings were consistent with mixed bipolar affective disorder. She also had generalised anxiety disorder. She was found to be hyper- focusing on her physical health and therefore was receiving high-dose fentanyl with clonazepam. Therefore, her bipolar affective disorder was treated with olanzapine and generalized anxiety disorder was treated with clonazepam [klonopin]. Within a period of one month after treating the bipolar affective disorder and generalized anxiety disorder, the woman was successfully liberated off of opioid. Author comment: "Chronic pain can mask or be http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Reactions Weekly Springer Journals

Fentanyl

Reactions Weekly , Volume 1704 (1) – Jun 2, 2018
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Fentanyl

Abstract

Reactions 1704, p161 - 2 Jun 2018 Opioid dependence: case report A 67-year-old woman developed opioid dependence during treatment with fentanyl for chronic back pain [duration of treatment to reaction onset not stated]. The woman had a history of chronic back pain due to multi- level prolapsed intervertebral discs, fibromyalgia, insomnia and depression. She was receiving fentanyl patch 200µg every 72 hours and clonazepam for the back pain for 12 years. She was referred to the...
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Publisher
Springer Journals
Copyright
Copyright © 2018 by Springer International Publishing AG, part of Springer Nature
Subject
Medicine & Public Health; Drug Safety and Pharmacovigilance; Pharmacology/Toxicology
ISSN
0114-9954
eISSN
1179-2051
DOI
10.1007/s40278-018-46804-8
Publisher site
See Article on Publisher Site

Abstract

Reactions 1704, p161 - 2 Jun 2018 Opioid dependence: case report A 67-year-old woman developed opioid dependence during treatment with fentanyl for chronic back pain [duration of treatment to reaction onset not stated]. The woman had a history of chronic back pain due to multi- level prolapsed intervertebral discs, fibromyalgia, insomnia and depression. She was receiving fentanyl patch 200µg every 72 hours and clonazepam for the back pain for 12 years. She was referred to the Rheumatology for suspected spondyloarthropathy. However, the rheumatologic work-up was negative. On re-evaluation, she reported that she always had mind-racing, crying, agitation, irritability, insomnia and depression. An examination revealed that she had poor insight, was anxious, depressed and agitated. All her findings were consistent with mixed bipolar affective disorder. She also had generalised anxiety disorder. She was found to be hyper- focusing on her physical health and therefore was receiving high-dose fentanyl with clonazepam. Therefore, her bipolar affective disorder was treated with olanzapine and generalized anxiety disorder was treated with clonazepam [klonopin]. Within a period of one month after treating the bipolar affective disorder and generalized anxiety disorder, the woman was successfully liberated off of opioid. Author comment: "Chronic pain can mask or be

Journal

Reactions Weekly – Springer Journals

Published: Jun 2, 2018

References

  • Unraveling the enigma of mental illness for successful treatment of opioid dependence.
    Yushuvayev, E