Reactions 1704, p242 - 2 Jun 2018 Cognitive dysfunction: case report A 58-year-old man developed cognitive dysfunction while receiving methadone and oxycodone [duration of treatment to reaction onset not stated]. The man, who was diagnosed with amyloid-associated peripheral neuropathy, started receiving treatment with oral methadone 40 mg 4 times daily along with several other medications for neuropathic pain. The treatment with methadone showed good response but the dose was not increased due to cognitive dysfunction, which had intensified with methadone treatment. Additionally, he also received oral oxycodone 80mg every 4 6 hours daily for breakthrough pain. Afterwards, he started receiving intrathecal hydromorphone. To avoid over-sedation, the dose of methadone was reduced to 10mg 2 times a day, while oxycodone was continued at a dose of 10 20 mg every 4 hours. The man was admitted for close monitoring of his pain. At the time of discharge, his methadone dose was reduced to 5mg 2 times daily while oxycodone was reduced by 25% in his daily usage. Subsequently, his cognitive function improved after reduced dependence on oral opioids. Author comment: "High-dose oral opioid therapy was only modestly successful in analgesic efficacy and was associated with substantial unwelcome effects including alterations in cognition." Warner NS, et al. Refractory Pain Management in Amyloid-Associated Peripheral Neuropathy. Regional Anesthesia and Pain Medicine 43: 434-437, No. 4, May 2018. Available from: URL: http://doi.org/10.1097/AAP.0000000000000733 - USA 803322967 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
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