• Sumeet S Panjabi, Ravi S Panjabi, Marvin D Shepherd, Kenneth A Lawson, Michael Johnsrud, and Jamie Barner.
• Elan Pharmaceuticals, Inc., South San Francisco, California, USA. sumeetp@mail.utexas.edu
• Pain Med. 2008 Nov 1;9(8):985-93.

ObjectiveTo evaluate the impact of an extended-release, once-daily morphine sulfate formulation on depressive symptoms and neurocognition in patients with chronic nonmalignant pain.DesignProspective, open-label, one-group trial with a pretest-posttest design.SettingOutpatient pain management clinic.Patients And InterventionChronic nonmalignant pain patients inadequately controlled with short-acting opioid analgesics and eligible for treatment with once-daily morphine sulfate were initiated on a dose at or near the morphine-equivalent dose of the short-acting regimen.OutcomesThe following assessments were made at baseline and 4 weeks after initiating intervention: pain intensity, pain unpleasantness, pain suffering, pain behaviors, Beck Depression Inventory, and cognitive function.ResultsEighty-four patients provided usable data. Pain intensity, unpleasantness, and suffering scores were significantly reduced at follow-up (P = 0.001). The mean Beck Depression Inventory scores were significantly lower at follow-up (P = 0.001). Significant improvements were seen in scores at follow-up on the three validated neurocognitive tests: the digit span test, the digit symbol substitution test, and the paced auditory serial addition test (P = 0.001).ConclusionsAchieving adequate pain control with once-daily morphine was associated with a reduction in pain and improvements in depressive symptoms and cognitive functioning in the short term.

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