• BMJ case reports · Nov 2015

    Case Reports

    Opioid-induced constipation reversal in response to placebo in a patient with a history of IBS receiving methadone maintenance therapy.

    • Andriy V Samokhvalov and Jürgen Rehm.
    • Social & Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Canada Addictions Program, Centre for Addiction and Mental Health, Toronto Canada.
    • BMJ Case Rep. 2015 Nov 13; 2015.

    AbstractOpioid-induced constipation (OIC) is one of the major side effects in patients receiving methadone maintenance treatment (MMT). Quite often, constipation becomes a factor significantly affecting therapeutic options and choices. Currently used approaches are symptomatic and in many cases ineffective. At the same time, it is well known that the gastrointestinal system is a subject for psychosomatic influences. In this case report, we describe an unexpected outcome of placebo administration in a patient suffering from OIC since her participation in MMT. The patient participated in a triple-blind randomised placebo-controlled trial of naloxone for treatment of OIC. As part of the study crossover design, the patient received 1 week of placebo followed by 1 week of naloxone, and had significant improvement in her bowel functioning when receiving placebo, then returned to baseline during the second week of the study.2015 BMJ Publishing Group Ltd.

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