[color=#333366]methadone in the treatment of neuropathic pain
b gagnon, a almahrezi, g schreier
background: methadone, being an n-methyl-d-aspartate receptor antagonist, may have a potential role in the treatment of neuropathic pain.
objectives: to evaluate the effect of methadone in the treatment of neuropathic pain and to estimate the possible dose ranges needed for pain control.
methods: methadone was offered as a treatment option to consecutive cancer and noncancer patients with neuropathic pain. pain intensity was measured by the visual analogue scale (vas) (0-10 cm where 0 = no pain and 10 = worst possible pain). mechanical allodynia and paroxysmal (shooting) pain were assessed clinically. all assessments were collected prospectively before treatment and once a stable dose of methadone was reached.
results: a total number of 18 patients met our inclusion criteria. the mean pretreatment vas ± sd was 7.7±1.5 cm and this dropped significantly to 1.4±1.7 cm on a stable dose of methadone (p<0.0001). nine of 13 patients (70 %) had a complete resolution of mechanical allodynia and all eight patients (100%) with shooting pain reported a complete response. the median stable dose of methadone was 15 mg per day.
conclusion: methadone at relatively low doses seems to be useful in the treatment of neuropathic pain.