Treatment of opioid-induced delirium with acetylcholinesterase inhibitors: A case report

Journal of Pain and Symptom Management

Volumn 27, Issue 3, 2004, Pages 268-273

  Slatkin, Neal ^a   Rhiner, Michelle ^a  

^a CITY OF HOPE NATIONAL MEDICAL CENTER   (United States)

Author keywords

Delirium; Donepezil; Physostigmine

Indexed keywords

ALPRAZOLAM; CEFALEXIN; CHOLINESTERASE INHIBITOR; CLONAZEPAM; DONEPEZIL; FENTANYL; FLUOXETINE; GABAPENTIN; GLYCOPYRRONIUM BROMIDE; HYDROMORPHONE; LAXATIVE; LEVOFLOXACIN; MORPHINE; OPIATE; PHYSOSTIGMINE; TRAZODONE;

ABDOMINAL ABSCESS; ADULT; ANAMNESIS; ARTICLE; CANCER PAIN; CASE REPORT; CHOLINERGIC SYSTEM; CLINICAL FEATURE; CONSTIPATION; DELIRIUM; DIAGNOSTIC PROCEDURE; DRUG INDUCED DISEASE; FEMALE; HUMAN; LABORATORY TEST; MYOCLONUS; NEUROTRANSMISSION; OVARY CANCER; SYMPTOM; TREATMENT OUTCOME;

EID: 1542298870     PISSN: 08853924     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.jpainsymman.2003.07.002     Document Type: Short Survey

References (54)

1. Lawlor P.G., Gagnon B., Mancini I.L., et al. Occurrence, causes, and outcome of delirium in patients with advanced cancer: a prospective study. Arch Intern Med. 160:(6):2000;786-794.
2. Morita T., Tei Y., Tsunoda J., et al. Underlying pathologies and their associations with clinical features in terminal delirium of cancer patients. J Pain Symptom Manage. 22:(6):2001;997-1006.
3. Tuma R., DeAngelis L.M. Altered mental status in patients with cancer. Arch Neurol. 57:(12):2000;1727-1731.
4. Bruera E., Neumann C.M. Opioid toxicities - assessment and management. Max M. Pain 1999 - an updated review: IASP Refresher Courses on Pain Management. 1999;IASP Press, Seattle.
5. Bruera E., Franco J.J., Maltoni M., et al. Changing pattern of agitated impaired mental status in patients with advanced cancer associated with cognitive monitoring, hydration, and opioid rotation. J Pain Symptom Manage. 10:1995;287-291.
6. Gagnon B., Bielech M., Watanabe S., et al. The use of intermittent subcutaneous injections of oxycodone for opioid rotation in patients with cancer pain. Support Care Cancer. 7:(4):1999;265-270.
7. Maddocks I., Somogyi A., Abbott F., et al. Attenuation of morphine-induced delirium in palliative care by substitution with infusion of oxycodone. J Pain Symptom Manage. 12:(3):1996;182-189.
8. Slatkin N.E., Rhiner M., Bolton T.M. Donepezil in the treatment of opioid-induced sedation: report of six cases. J Pain Symptom Manage. 21:(5):2001;425-438.
9. Slatkin N.E., Rhiner M. Treatment of opiate related sedation: utility of cholinesterase inhibitors. J Supp Oncol. 1:(1):2003;53-63.
10. Weinstock M., Davidson J.T., Rosin A.J., et al. Effect of physostigmine on morphine-induced postoperative pain and somnolence. Br J Anaesth. 54:(4):1982;429-434.
11. Sternbach H., State R. Antibiotics: neuropsychiatric effects and psychotropic interactions. Harvard Rev Psychiatry. 5:(4):1997;214-226.
12. Breitbart W., Rosenfeld B., Roth A., et al. The Memorial Delirium Assessment Scale. J Pain Symptom Manage. 13:(3):1997;128-137.
13. Zajecka J., Fawcett J., Amsterdam J., et al. Safety of abrupt discontinuation of fluoxetine: a randomized, placebo-controlled study. J Clin Psychopharmacol. 18:(3):1998;193-197.
14. Bruera E., Franco J.J., Maltoni M., et al. Changing pattern of agitated impaired mental status in patients with advanced cancer: association with cognitive monitoring, hydration, and opioid rotation. J Pain Symptom Manage. 10:(4):1995;287-291.
15. Triggle D.J., Mitchell J.M., Filler R. The pharmacology of physostigmine. CNS Drug Rev. 4:(2):1998;87-136.
16. Jones B.E. The organization of central cholinergic systems and their functional importance in sleep-waking states. Prog Brain Res. 98:1993;61-71.
17. Sarter M., Bruno J.P. Cognitive functions of cortical acetylcholine: toward a unifying hypothesis. Brain Res Brain Res Rev. 23:(1-2):1997;28-46.
18. Perry E., Walker M., Grace J., et al. Acetylcholine in mind: a neurotransmitter correlate of consciousness? Trends Neurosci. 22:(6):1999;273-280.
19. Muir J.L., Page K.J., Sirinathsinghji D.J., et al. Excitotoxic lesions of basal forebrain cholinergic neurons: effects on learning, memory and attention. Behav Brain Res. 57:(2):1993;123-131.
20. Molchan S.E., Martinez R.A., Hill J.L., et al. Increased cognitive sensitivity to scopolamine with age and a perspective on the scopolamine model. Brain Res Brain Res Rev. 17:(3):1992;215-226.
21. Cheal M.L. Scopolamine disrupts maintenance of attention rather than memory processes. Behav Neural Biol. 33:(2):1981;163-187.
22. Sarter M., Bruno J.P., Turchi J. Basal forebrain afferent projections modulating cortical acetylcholine, attention, and implications for neuropsychiatric disorders. Ann NY Acad Sci. 877:1999;368-382.
23. Kaufer D.I., Cummings J.L., Christine D. Effect of tacrine on behavioral symptoms in Alzheimer's disease: an open-label study. J Geriatr Psychiatry Neurol. 9:1996;1-6.
24. Feldman H., Gauthier S., Hecker J., et al. A 24-week, randomized, double-blind study of donepezil in moderate to severe Alzheimer's disease. Neurology. 57:(4):2001;613-620.
25. Reading P.J., Luce A.K., McKeith I.G. Rivastigmine in the treatment of parkinsonian psychosis and cognitive impairment: preliminary findings from an open trial. Mov Disord. 16:(6):2001;1171-1174.
26. Tariot P.N., Solomon P.R., Morris J.C., et al. A 5-month, randomized, placebo-controlled trial of galantamine in AD. The Galantamine USA-10 Study Group. Neurology. 54:(12):2000;2269-2276.
27. Aizawa K., Kanai T., Saikawa Y., et al. A novel approach to the prevention of postoperative delirium in the elderly after gastrointestinal surgery. Surg Today. 32:(4):2002;310-314.
28. Lydic R., Baghdoyan H.A. Pedunculopontine stimulation alters respiration and increases ACh release in the pontine reticular formation. Am J Physiol. 264:(3 Pt 2):1993;R544-R554.
29. Lydic R., Keifer J.C., Baghdoyan H.A., et al. Microdialysis of the pontine reticular formation reveals inhibition of acetylcholine release by morphine. Anesthesiology. 79:(5):1993;1003-1012.
30. Baghdoyan H.A., Monaco A.P., Rodrigo-Angulo M.L., et al. Microinjection of neostigmine into the pontine reticular formation of cats enhances desynchronized sleep signs. J Pharmacol Exp Ther. 231:(1):1984;173-180.
31. Baghdoyan H.A., Lydic R., Callaway C.W., et al. The carbachol-induced enhancement of desynchronized sleep signs is dose dependent and antagonized by centrally-administered atropine. Neuropsychopharmacology. 2:(1):1989;67-79.
32. Hobson J.A., McCarley R.W., Wyzinski P.W. Sleep cycle oscillation: reciprocal discharge by two brainstem neuronal groups. Science. 189:(4196):1975;55-58.
33. Tune L.E., Damlouji N.F., Holland A., et al. Association of postoperative delirium with raised serum levels of anticholinergic drugs. Lancet. 2:(8248):1981;651-653.
34. Flacker J.M., Cummings V., Mach J.R. Jr., et al. The association of serum anticholinergic activity with delirium in elderly medical patients. Am J Geriatr Psychiatry. 6:(1):1998;31-41.
35. Beleslin D., Polak R. Depression by morphine and cholralose of acetylcholine release from the cat's brain. J Physiol (Lond). 177:1965;411-419.
36. Jhamandas K., Sutak M. Morphine-naloxone interaction in the central cholinerigc system: the influence of subcortical lesioning and electrical stimulation. Br J Pharmac. 58:1976;101-107.
37. Yaksh T., Yamamura H. Depression by morphine of the resting and evoked release of [3H]-acetylcholine from the cat caudate nucleus in-vivo. Neuropharmacology. 16:1977;227-233.
38. Rada P., Mark G., Pothos E., et al. Systemic morphine administration decreases extracellular acetycholine and increases dopamine in the nucleus accumbens of freely moving rats. Neuropharmacology. 30:1991;1133-1136.
39. Domino E.F., Wilson A.E. Enhanced utilization of brain ACh during morphine withdrawal in the rat. Nature. 243:1973;285-286.
40. Sandor N.T., Lendvai B., Vizi E.S. Effect of selective opiate antagonists on striatal acetylcholine and dopamine release. Brain Res Bull. 29:(3-4):1992;369-373.
41. Mortazavi S., Thompson J., Baghdoyan H.A., et al. Fentanyl and morphine, but not remifentanil, inhibit acetylcholine release in pontine regions modulating arousal. Anesthesiology. 90:(4):1999;1070-1077.
42. Kay D.C., Eisenstein R.B., Jasinski D.R. Morphine effects on human REM state, waking state and NREM sleep. Psychopharmacologia. 14:(5):1969;404-416.
43. Kay D.C. Human sleep during chronic morphine intoxication. Psychopharmacologia. 44:(2):1975;117-124.
44. Muir J.L., Robbins T.W., Everitt B.J. Disruptive effects of muscimol infused into the basal forebrain on conditional discrimination and visual attention: differential interactions with cholinergic mechanisms. Psychopharmacology (Berl). 107:(4):1992;541-550.
45. Muir J.L., Everitt B.J., Robbins T.W. Reversal of visual attentional dysfunction following lesions of the cholinergic basal forebrain by physostigmine and nicotine but not by the 5-HT3 receptor antagonist, ondansetron. Psychopharmacology (Berl). 118:(1):1995;82-92.
46. Sitaram N., Moore A.M., Gillin J.C. The effect of physostigmine on normal human sleep and dreaming. Arch Gen Psychiatry. 35:(10):1978;1239-1243.
47. Burns M.J., Linden C.H., Graudins A., et al. A comparison of physostigmine and benzodiazepines for the treatment of anticholinergic poisoning. Ann Emerg Med. 35:(4):2000;374-381.
48. Crowell E.B. Jr., Ketchum J.S. The treatment of scopolamine-induced delirium with physostigmine. Clin Pharmacol Ther. 8:(3):1967;409-414.
49. Shulman M.S., Sandler A., Brebner J. The reversal of epidural morphine induced somnolence with physostigmine. Can Anaesth Soc J. 31:(6):1984;678-680.
50. Petersson J., Gordh T.E., Hartvig P., et al. A double-blind trial of the analgesic properties of physostigmine in postoperative patients. Acta Anaesthesiol Scand. 30:(4):1986;283-288.
51. Nemirovsky A., Niv D. Cholinergic mechanisms and antinociception. Curr Rev Pain. 1:1996;10-22.
52. Green P.G., Kitchen I. Antinociception opioids and the cholinergic system. Prog Neurobiol. 26:(2):1986;119-146.
53. Bouaziz H., Tong C., Eisenach J.C. Postoperative analgesia from intrathecal neostigmine in sheep. Anesth Analg. 80:(6):1995;1140-1144.
54. Schott G.D., Loh L. Anticholinesterase drugs in the treatment of chronic pain. Pain. 20:(2):1984;201-206.