Abstract | OBJECTIVE: METHOD: From the series of cancer patients undergoing symptom management, we report a case treated with naldemedine for constipation in relation to the use of opioids for cancer pain and who displayed severe psychological symptoms associated with withdrawal immediately after the use of naldemedine. RESULTS: The patient was a 36-year-old woman diagnosed with cervical cancer Stage IIB, PS3. When the patient, who was using oxycodone hydrochloride hydrate (80 mg/day) for ileal pain, was started on naldemedine for constipation, she complained of sweating after just 5 min and hallucinations after 1 h. The patient also displayed physical/behavioral abnormalities such as diarrhea and hyperactivity, and psychological abnormalities such as aggression toward staff.Despite the psychiatric symptoms worsening over time, there were no abnormalities in terms of blood biochemical data, and no brain metastasis was observed on MRI. Based on the Clinical Opiate Withdrawal Scale, these symptoms were judged to indicate opioid withdrawal. Naldemedine was discontinued due to naldemedine-related opioid withdrawal syndrome and, thereafter, the psychiatric symptoms diminished, with no recurrence of similar symptoms observed to date. SIGNIFICANCE OF RESULTS: If mental and behavioral abnormalities occur in patients receiving naldemedine, it is necessary to consider the possibility of opioid withdrawal syndrome as a differential diagnosis.
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Authors | Mayumi Ishida, Mie Hiraoka, Ayako Yaguchi, Koji Sugano, Nasako Adachi, Tomoko Itoga, Tomohito Ishiguro, Hideki Onishi |
Journal | Palliative & supportive care
(Palliat Support Care)
Vol. 20
Issue 3
Pg. 445-447
(06 2022)
ISSN: 1478-9523 [Electronic] England |
PMID | 34955117
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Analgesics, Opioid
- Narcotic Antagonists
- naldemedine
- Naltrexone
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Topics |
- Adult
- Analgesics, Opioid
(adverse effects)
- Brain Neoplasms
(chemically induced, drug therapy)
- Constipation
(chemically induced, drug therapy)
- Female
- Humans
- Naltrexone
(analogs & derivatives)
- Narcotic Antagonists
(adverse effects)
- Uterine Cervical Neoplasms
(complications, drug therapy)
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