Potential impact of abrupt opioid therapy discontinuation in the management of chronic pain: a pilot study on patient perspective.

Objectives: This survey highlights the perspective of patients with chronic pain when confronted with the possibility of abrupt opioid discontinuation.

Design: Anonymous and self-administered survey.

Setting: Pain Clinic in an urban academic hospital setting.

False sense of safety by daily QTc interval monitoring during methadone IVPCA titration in a patient with chronic pain.

It has been proposed that some deaths attributed to methadone are related to prolongation of the QTc interval; however, there are no clear recommendations on electrocardiogram (ECG) monitoring in patients undergoing intravenous methadone infusion. This is a report on a patient receiving methadone intravenous patient-controlled analgesia titration for the treatment of chronic pain. Initially, her daily ECGs showed QTc intervals within normal limits; however, she experienced a rapid increase in QTc interval from 317 ms to 784 ms within a 24-hour period after methadone had been discontinued for excessive sedation.

Effects of central leptin infusion on the reward-potentiating effect of D-amphetamine.

It was previously reported that chronic food restriction and maintenance of rats at 75-80% of initial body weight enhanced the reward-potentiating effect of D-amphetamine in the lateral hypothalamic self-stimulation (LHSS) paradigm. Moreover, the enhancement reversed in parallel with body weight recovery when ad libitum access to food was reinstated. The present study tested the hypothesis that hypoleptinemia during food restriction is necessary for expression of enhanced drug reward.