title: Endocrine and behavioural effects of transdermal buprenorphine in pain-suffering women of different reproductive ages.
abstract: Chronic pain is a common problem in clinical practice and women are affected more often than men. Morphine is often used for long-term pain relief, but it induces side effects including endocrine alterations. The aim of the present study was to assess the behavioural and hormonal effects of transdermal buprenorphine in women suffering from persistent non-malignant pain. Hormones (LH, FSH, total and free testosterone, estradiol, cortisol) and pain measures (visual analogue scale, McGill Pain questionnaire, present pain intensity test) were evaluated at baseline and after 1, 3 and 6 months. Subjects were recruited in the Second University of Naples Pain Research Centre. Eighteen chronic pain women were included in the study, divided into pre- and post-menopausal groups. A transdermal buprenorphine patch (Buprenorphine TDS, 35 µg/h) was administered every 72 h. As expected, buprenorphine administration led to a decrease in pain intensity and no side effects suggestive of hypogonadism were recorded. Pain measures decreased at the first control visit (T1) in both groups. Total and free testosterone were not reduced by treatment (they tended to increase in both groups) while cortisol progressively recovered from the quite low levels detected at the beginning of treatment. These data confirm that buprenorphine is a safe and effective drug for pain relief in women. It is free from the adverse effects on gonadal hormones frequently associated with other opioid treatments. The lack of opioid-induced effects on gonadal hormones (i.e., hypogonadism) is important to guarantee safe long-term pain treatment.
authors.affiliation: Second University of Naples, Department of Anaesthesiological, Surgical and Emergency Sciences, Naples, Italy. caterina.aurilio@unina2.it
authors.forename: Caterina
authors.initials: C
authors.lastname: Aurilio
authors.forename: Ilaria
authors.initials: I
authors.lastname: Ceccarelli
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Pota
authors.forename: Pasquale
authors.initials: P
authors.lastname: Sansone
authors.forename: Cosimo
authors.initials: C
authors.lastname: Massafra
authors.forename: Manlio
authors.initials: M
authors.lastname: Barbarisi
authors.forename: Maria Caterina
authors.initials: MC
authors.lastname: Pace
authors.forename: Maria Beatrice
authors.initials: MB
authors.lastname: Passavanti
authors.forename: Fabio
authors.initials: F
authors.lastname: Bravi
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Aloisi
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D002047:Buprenorphine / Q000008:administration & dosage*; D059350:Chronic Pain / Q000188:drug therapy*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008875:Middle Aged; D058850:Opiate Substitution Treatment / Q000379:methods*; D017698:Postmenopause; D017697:Premenopause; D011446:Prospective Studies; D013739:Testosterone / Q000097:blood
chemical_list: D013739:Testosterone; D002047:Buprenorphine; D006854:Hydrocortisone