• Pain Res Manag · Jan 2003

    Methadone in the treatment of neuropathic pain.

    • Bruno Gagnon, Abdulaziz Almahrezi, and Gil Schreier.
    • Royal Victoria Hospital, Montreal, Canada. bruno.gagnon@clinepi.mcgill.ca
    • Pain Res Manag. 2003 Jan 1; 8 (3): 149-54.

    BackgroundMethadone, being an N-Methyl-D-Aspartate receptor antagonist, may have a potential role in the treatment of neuropathic pain.ObjectivesTo evaluate the effect of methadone in the treatment of neuropathic pain and to estimate the possible dose ranges needed for pain control.MethodsMethadone was offered as a treatment option to consecutive cancer and noncancer patients with neuropathic pain. Pain intensity was measured by the visual analogue scale (VAS) (0-10 cm where 0 = no pain and 10 = worst possible pain). Mechanical allodynia and paroxysmal (shooting) pain were assessed clinically. All assessments were collected prospectively before treatment and once a stable dose of methadone was reached.ResultsA total number of 18 patients met our inclusion criteria. The mean pretreatment VAS +/- SD was 7.7+/-1.5 cm and this dropped significantly to 1.4+/-1.7 cm on a stable dose of methadone (P<0.0001). Nine of 13 patients (70 %) had a complete resolution of mechanical allodynia and all eight patients (100%) with shooting pain reported a complete response. The median stable dose of methadone was 15 mg per day.ConclusionMethadone at relatively low doses seems to be useful in the treatment of neuropathic pain.

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