Current Oncology Reports

, Volume 8, Issue 4, pp 282–288

Methadone for treatment of cancer pain

  • John Bryson
  • Anoo Tamber
  • Dori Seccareccia
  • Camilla Zimmermann
Article

DOI: 10.1007/s11912-006-0034-4

Cite this article as:
Bryson, J., Tamber, A., Seccareccia, D. et al. Curr Oncol Rep (2006) 8: 282. doi:10.1007/s11912-006-0034-4

Abstract

Methadone is a unique μ opioid agonist, which also has δ receptor affinity and properties of N-methyl-D-aspartate receptor antagonism and monoamine reuptake inhibition. It is mainly used in the setting of uncontrolled pain or dose-limiting toxicity. Caution is advised when switching to methadone, especially from high doses of previous opioid, due to its variable conversion ratio and the potential for delayed toxicity due to its long half-life. Increasing evidence of risk also exists for a prolonged QT interval and torsades de pointes with very large doses of methadone. Methadone is likely safer when used at lower doses as a first-line opioid, but its potential as such has not received enough formal evaluation. Randomized controlled trials are needed to assess the effectiveness and safety of methadone compared with other opioids and to further evaluate its role in the treatment of neuropathic pain.

Copyright information

© Current Science Inc 2006

Authors and Affiliations

  • John Bryson
  • Anoo Tamber
  • Dori Seccareccia
  • Camilla Zimmermann
    • 1
  1. 1.Division of Medical Oncology and Hematology, Psychosocial Oncology and Palliative Care ProgramPrincess Margaret HospitalTorontoCanada