Open AccessExtended‐Release, Once‐Daily Morphine (Avinza) for the Treatment of Chronic Nonmalignant Pain: Effect on Pain, Depressive Symptoms, and Cognition
Author(s) -
Panjabi Sumeet S.,
Panjabi Ravi S.,
Shepherd Marvin D.,
Lawson Kenneth A.,
Johnsrud Michael,
Barner Jamie
Publication year - 2008
Publication title -
pain medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.893
H-Index - 97
eISSN - 1526-4637
pISSN - 1526-2375
DOI - 10.1111/j.1526-4637.2008.00483.x
Subject(s) - medicine , digit symbol substitution test , chronic pain , beck depression inventory , neurocognitive , brief pain inventory , morphine , depression (economics) , physical therapy , opioid , pain catastrophizing , neuropathic pain , cognition , anesthesia , psychiatry , anxiety , pathology , placebo , alternative medicine , receptor , economics , macroeconomics
Objective. To evaluate the impact of an extended‐release, once‐daily morphine sulfate formulation on depressive symptoms and neurocognition in patients with chronic nonmalignant pain. Design. Prospective, open‐label, one‐group trial with a pretest–posttest design. Setting. Outpatient pain management clinic. Patients and Intervention. Chronic nonmalignant pain patients inadequately controlled with short‐acting opioid analgesics and eligible for treatment with once‐daily morphine sulfate were initiated on a dose at or near the morphine‐equivalent dose of the short‐acting regimen. Outcomes. The following assessments were made at baseline and 4 weeks after initiating intervention: pain intensity, pain unpleasantness, pain suffering, pain behaviors, Beck Depression Inventory, and cognitive function. Results. Eighty‐four patients provided usable data. Pain intensity, unpleasantness, and suffering scores were significantly reduced at follow‐up ( P = 0.001). The mean Beck Depression Inventory scores were significantly lower at follow‐up ( P = 0.001). Significant improvements were seen in scores at follow‐up on the three validated neurocognitive tests: the digit span test, the digit symbol substitution test, and the paced auditory serial addition test ( P = 0.001). Conclusions. Achieving adequate pain control with once‐daily morphine was associated with a reduction in pain and improvements in depressive symptoms and cognitive functioning in the short term.