Non-Analgesic Effects of Opioids: The Cognitive Effects of Opioids in Chronic Pain of Malignant and Non-Malignant Origin. An Update.
Two previous systematic reviews on cancer pain and non-cancer pain patients only using controlled studies were updated. Fourteen controlled studies on the cognitive effects of opioids in chronic non-cancer pain patients and eleven controlled studies in cancer pain patients were included and analyzed.
Opioid treatment involved slightly opposite outcomes in the two patient groups: no effects or worsening of cognitive function in cancer pain patients and no effect or improvements in the chronic non-cancer pain patients, however, due to methodological limitations and a huge variety of designs definite conclusions are difficult to draw from the studies. In studies of higher quality of evidence opioid induced deficits in cognitive functioning were associated with dose increase and the use of supplemental doses of opioids in cancer patients.
Future perspectives should comprise the conduction of high quality randomized controlled trials (RCTs) involving relevant control groups and validated neuropsychological assessments tools before and after opioid treatment in order to further explore the complex interaction between pain, opioids and cognition.
Keywords: Opioid; cancer pain; central nervous system; chronic pain; cognition; controlled studies; neuropsychological assessment; randomized controlled trials (RCTs); supplemental doses; systematic review
Document Type: Research Article
Publication date: December 1, 2012
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