Been having some terrific N=1 successes recently using adjuvant methadone in resistant neuropathic cancer pain.
This Canadian group lead by Dr Courtemanche in Quebec followed 150 ish patients with cancer neuropathic pain who had low dose methadone added as an adjunct. They found that half the patient responded, where response was defined as a greater than 30% decrease in pain intensity. Median time to response was 7 days. Formidable!
In the same issue of the Journal of Pain and Symptom Management, a Japanese team lead by Dr Sakamoto in Nagoya found that pain intensity was reduced in most of the 28 patients who were rotated to methadone from other opioids with neuropathic pain caused by cancer. Sugoi!
Methadone… do you love it? Hate it? Fear it?