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, 39 (4), 727-31

Pharmacologic Treatment of Opioid-Induced Sedation in Chronic Pain


Pharmacologic Treatment of Opioid-Induced Sedation in Chronic Pain

James E Reissig et al. Ann Pharmacother.


Objective: To review the literature for pharmacologic management of opioid-induced sedation (OIS) in patients with chronic pain.

Data sources: A search of MEDLINE (1966-October 2004) for English-language literature and selected bibliographies was completed. Search terms included pain, opioid, sedation, psychostimulants, amphetamines, modafinil, and donepezil.

Data synthesis: Amphetamines and amphetamine-like agents, caffeine, donepezil, and modafinil have been evaluated for OIS. Available literature is limited by numbers of subjects, duration, and trial design; however, there is limited support for the use of methylphenidate, donepezil, and modafinil.

Conclusions: Pharmacologic treatment of OIS should be utilized selectively, given the available literature. Methylphenidate, donepezil, and modafinil may be considered in appropriate patients.

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