Opioid induced hyperalgesia and effects of low doses of naloxone

Zbigniew Żylicz

Vol 3, No 1 (2004): Polish Palliative Medicine

Case reports

Published online: 2003-10-27

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Opioid induced hyperalgesia and effects of low doses of naloxone

Zbigniew Żylicz

Advances in Palliative Medicine 2004;3(1):67-70.

Vol 3, No 1 (2004): Polish Palliative Medicine

Case reports

Published online: 2003-10-27

Abstract

Opioids are used for their pain relieving, analgesic effect. However in some patients the same drugs are able to act in opposite way and to induce hyperalgesia. This opioid induced hyperalgesia is responsible for development of tolerance to opioids. In the case report presented here, we observed development of tolerance to fetanyl, accompanied by marked delirium. Ultra low doses of naloxone (0.20 mg/24 hours) are known to inhibit opioid receptors being in excitatory mode. This treatment resulted in rapid improvement of both analgesia and of cognitive functions. The meaning of this observation and explanation of this phenomenon are discussed in detail.