• J Opioid Manag · Mar 2007

    Case Reports

    Using methadone to treat opioid-induced hyperalgesia and refractory pain.

    • David J Axelrod and Barbara Reville.
    • Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
    • J Opioid Manag. 2007 Mar 1;3(2):113-4.

    AbstractA patient was treated for several years with high doses of opioids for malignant pain. During a recent hospitalization, the patient's pain remained uncontrolled despite escalating doses of various opioids. We suspected that this patient suffered from the clinical phenomenon of opioid-induced hyperalgesia (OIH). The patient was then rotated from her other opioids to methadone, and her pain was adequately controlled within several days. Methadone, because of its NMDA antagonist properties, offers an effective treatment for OIH. The use of methadone for analgesia is complex and should be undertaken only by practitioners who have appropriate experience.

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