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|American Society for Action on Pain|
Author: MacDonald-N. Der-L. Allan-S. Champion-P.
Title: Opioid hyperexcitability: the application of alternate opioid therapy.
Source: Pain. 1993 Jun. 53(3). P 353-5.
Journal Title: PAIN.
Abstract: Three cases are reported where patients experienced severe central nervous system adverse effects on high-dose hydromorphone. These effects were rapidly alleviated following a change in therapy to morphine at 20-25% of the usually accepted potency equivalent dose. We recommend caution in using equivalent dose tables when changing opioid therapy in patients receiving high-dose opioid treatment.