Pharmacologic Treatment of Opioid-Induced Sedation in Chronic Pain

@article{Reissig2005PharmacologicTO,
  title={Pharmacologic Treatment of Opioid-Induced Sedation in Chronic Pain},
  author={James E Reissig and Amy M Rybarczyk},
  journal={Annals of Pharmacotherapy},
  year={2005},
  volume={39},
  pages={727 - 731}
}
OBJECTIVE: To review the literature for pharmacologic management of opioid-induced sedation (OIS) in patients with chronic pain. DATA SOURCES: A search of MEDLINE (1966–October 2004) for English-language literature and selected bibliographies was completed. Search terms included pain, opioid, sedation, psychostimulants, amphetamines, modafinil, and donepezil. DATA SYNTHESIS: Amphetamines and amphetamine-like agents, caffeine, donepezil, and modafinil have been evaluated for OIS. Available… 

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References

SHOWING 1-10 OF 28 REFERENCES

Donepezil in the treatment of opioid-induced sedation: report of six cases.

Modafinil treatment of opioid-induced sedation.

The results suggest an improvement in opioid-induced sedation in patients treated for nonmalignant pain, as measured using Epworth Sleepiness Scale.

Current management of opioid-related side effects.

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A randomized, crossover evaluation of methylphenidate in cancer patients receiving strong narcotics

It is suggested that methylphenidate can counteract narcotic-induced daytime sedation to a limited degree and could mildly decrease narcotics-induced drowsiness and could increase night-time sleep.

Definition of and mechanism for opioid-induced sedation.

A definition of opioid-induced sedation is proposed to encourage dialogue and research on this perplexing and clinically significant phenomenon.

Prevention of opioid side effects.

  • T. Walsh
  • Medicine
    Journal of pain and symptom management
  • 1990