Vol 7, No 4 (2008)
Case reports
Published online: 2008-10-21
Discontinuing opioids in a safe way. Case report and recommendations for Palliative Care
Sohail Ahmed, Zbigniew Zylicz
Advances in Palliative Medicine 2008;7(4):175-178.
Vol 7, No 4 (2008)
Case reports
Published online: 2008-10-21
Abstract
Opioids are the mainstay of pain treatment in cancer. In the course of disease many patients will experience
increase of pain intensity and hence need an increase of the opioid dose. However, in some situations, when
for example the other treatment of pain is effective, the dose of opioids could and should be decreased or
even discontinued. Many patients continue on the opioids because it is unclear how and when to discontinue
them. We present the case of a patient treated for his pain with opioids. Opioids were responsible for vivid
delirium, probably exacerbating subclinical dementia. Treatment with steroid injections allowed to decrease
and later discontinuation of opioids with a clear gain in lucidity and cognitive functioning by the patient. We
propose the guidelines how and when to wean patients from the opioids. Buprenorphine and clonidine, but
possibly also gabapentin may play a role in the prevention and pharmacological treatment of the symptoms
of abstinence.
Abstract
Opioids are the mainstay of pain treatment in cancer. In the course of disease many patients will experience
increase of pain intensity and hence need an increase of the opioid dose. However, in some situations, when
for example the other treatment of pain is effective, the dose of opioids could and should be decreased or
even discontinued. Many patients continue on the opioids because it is unclear how and when to discontinue
them. We present the case of a patient treated for his pain with opioids. Opioids were responsible for vivid
delirium, probably exacerbating subclinical dementia. Treatment with steroid injections allowed to decrease
and later discontinuation of opioids with a clear gain in lucidity and cognitive functioning by the patient. We
propose the guidelines how and when to wean patients from the opioids. Buprenorphine and clonidine, but
possibly also gabapentin may play a role in the prevention and pharmacological treatment of the symptoms
of abstinence.
Keywords
opioids; pain therapy; discontinuing opioids
Title
Discontinuing opioids in a safe way. Case report and recommendations for Palliative Care
Journal
Advances in Palliative Medicine
Issue
Vol 7, No 4 (2008)
Pages
175-178
Published online
2008-10-21
Page views
500
Article views/downloads
1431
Bibliographic record
Advances in Palliative Medicine 2008;7(4):175-178.
Keywords
opioids
pain therapy
discontinuing opioids
Authors
Sohail Ahmed
Zbigniew Zylicz