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Pain Research and Management
Volume 8, Issue 3, Pages 149-154
Original Article

Methadone in the Treatment of Neuropathic Pain

Bruno Gagnon,1 Abdulaziz Almahrezi,2 and Gil Schreier3

1Department of Oncology, Division of Palliative Care, McGill University Heath Centre, Canada
2MGH Pain Centre, McGill University, Montreal General Hospital, Montreal, Quebec, Canada
3Pain and Palliative Care Service, Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA

Copyright © 2003 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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.