Pharmacologic Treatment of Opioid-Induced Sedation in Chronic Pain

  title={Pharmacologic Treatment of Opioid-Induced Sedation in Chronic Pain},
  author={James E Reissig and Amy M Rybarczyk},
  journal={Annals of Pharmacotherapy},
  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… 

Tables from this paper

Cognitive Effects and Sedation.

CES is prevalent in chronic nonmalignant pain populations receiving long-term opioid therapy and are among the most common reasons patients discontinue opioid use, particularly among the elderly.

Opioid complications and side effects.

The role of opioids in the treatment of chronic pain is influenced by the fact that these potent analgesics are associated with a significant number of side effects and complications, and these phenomena are the focus of this review.

Evaluation of concomitant methylphenidate and opioid use in patients with pain.

The current study observed differences in the use pattern of methylphenidate based on opioid type, with methadone having the highest percent difference between the sample and baseline populations (77%, P ≤ 0.05).

Extended-release opioids for the management of chronic non-malignant pain

The clinical pharmacology of investigational and current marketed ER opioids and current technologies aimed at defeating the abuse of ER opioids will be presented.

Assessing and Managing Opioid-Related Side Effects in Children and Adolescents

A thorough knowledge of the mechanism of action of opioids is critical to the understanding of the pathogenesis of the various opioid-related side effects and facilitates appropriate prophylactic and therapeutic interventions to mitigate the incidence and severity of the same.

Opioid Analgesics Adverse Effects:The Other Side Of The Coin.

Intensity of adverse effects tend to decrease with continuous use, however, they may be persistent and may require symptomatic treatment or more complex treatment including alternative strategies for pain management.

Opioid Adverse Effects and Opioid-Induced Hypogonadism

This chapter will review opioid-related nausea and vomiting, constipation, neuroendocrine effects, immune effects, respiratory depression, central nervous system effects, and pruritis.

The effect of opioids on sleep architecture.

Single doses of oral opioid medications can significantly affect sleep architecture in healthy adults, and observed reductions in slow-wave sleep following opioid administration may have important implications for the pathogenesis of opioid-use related fatigue.

Investigating the analgesic properties of Kurkinorin, a novel mu-opioid receptor analogue of Salvinorin A

Kurkinorin has been identified as a structurally new class of mu-opioid analgesic, displaying improvements compared to morphine, and is as potent as morphine in attenuating acute nociceptive and inflammatory pain.



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.

The optimal management of opioid-related side effects is hampered by a lack of comparative studies of management strategies. The prevalence of such side effects is influenced by the extent of

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