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Regular, low-dose methadone for reducing breathlessness in people experiencing or at risk of neurotoxic effects from morphine: A single-center case series.
Front Med (Lausanne)
December 2022
Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.
Breathlessness is a common symptom suffered by people living with advanced malignant and non-malignant diseases, one which significantly limits their quality of life. If it emerges at minimal exertion, despite the maximal, guidelines-directed, disease-specific therapies, it should be considered persistent and obliges clinicians to prescribe symptomatic, non-pharmacological, and pharmacological treatment to alleviate it. Opioids are recommended for the symptomatic treatment of persistent breathlessness, with morphine most extensively studied for this indication.
View Article and Find Full Text PDFLow-Dose Naltrexone (LDN)-Review of Therapeutic Utilization.
Med Sci (Basel)
September 2018
Section of Pain Medicine, Department of Anesthesiology, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr, Lebanon, NH 03756, USA.
Naltrexone and naloxone are classical opioid antagonists. In substantially lower than standard doses, they exert different pharmacodynamics. Low-dose naltrexone (LDN), considered in a daily dose of 1 to 5 mg, has been shown to reduce glial inflammatory response by modulating Toll-like receptor 4 signaling in addition to systemically upregulating endogenous opioid signaling by transient opioid-receptor blockade.
View Article and Find Full Text PDFVery-Low-Dose Methadone To Treat Refractory Neuropathic Pain in Children with Cancer.
J Palliat Med
November 2017
M.D. Anderson Cancer Center, University of Texas, Houston, Texas.
Background: Compared with nociceptive pain, neuropathic pain is a challenging diagnosis to make and successfully treat in children with cancer.
Objective: The objective of this case report was to see whether very-low-dose methadone (VLDM) (defined as <50% of accepted starting analgesic dose of methadone for children) would be an effective strategy to treat refractory neuropathic pain due to vincristine in two children with acute lymphoblastic leukemia.
Methods: This case report is based on the clinical experience and parent-reported outcomes of two children with refractory neuropathic pain who received VLDM.
Use of Very-Low-Dose Methadone and Haloperidol for Pain Control in Palliative Care Patients: Are the Sigma-1 Receptors Involved?
J Palliat Med
August 2015
Department of Pharmacology, Neuroscience Institute and Biosanitary Research Institute, University of Granada Medical School, Granada, Spain .
The use of very-low-dose methadone and haloperidol for pain control in the hospital setting: a preliminary report.
J Palliat Med
February 2015
1 Stanford University School of Medicine, Stanford, California.
Objective: Our aim was to evaluate the use of very-low-dose methadone with haloperidol in the acute-care setting.
Methods: We reviewed the records of 735 hospitalized patients receiving a palliative care consultation between 2011 and 2014. All patients with pain on opiates were offered conversion to methadone, 2.
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