title: Opioid-induced constipation reversal in response to placebo in a patient with a history of IBS receiving methadone maintenance therapy.
abstract: Opioid-induced constipation (OIC) is one of the major side effects in patients receiving methadone maintenance treatment (MMT). Quite often, constipation becomes a factor significantly affecting therapeutic options and choices. Currently used approaches are symptomatic and in many cases ineffective. At the same time, it is well known that the gastrointestinal system is a subject for psychosomatic influences. In this case report, we describe an unexpected outcome of placebo administration in a patient suffering from OIC since her participation in MMT. The patient participated in a triple-blind randomised placebo-controlled trial of naloxone for treatment of OIC. As part of the study crossover design, the patient received 1 week of placebo followed by 1 week of naloxone, and had significant improvement in her bowel functioning when receiving placebo, then returned to baseline during the second week of the study.
authors.affiliation: Social & Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Canada Addictions Program, Centre for Addiction and Mental Health, Toronto Canada.
authors.forename: Andriy V
authors.initials: AV
authors.lastname: Samokhvalov
authors.affiliation: Social & Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Canada.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Rehm
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects*; D003248:Constipation / Q000139:chemically induced* / Q000188:drug therapy; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications* / Q000188:drug therapy; D054368:Laxatives / Q000008:administration & dosage; D008691:Methadone / Q000008:administration & dosage / Q000009:adverse effects*; D008875:Middle Aged; D009270:Naloxone / Q000008:administration & dosage / Q000009:adverse effects*; D009292:Narcotic Antagonists / Q000008:administration & dosage / Q000009:adverse effects*; D009294:Narcotics / Q000008:administration & dosage / Q000009:adverse effects*; D058850:Opiate Substitution Treatment / Q000009:adverse effects*; D017060:Patient Satisfaction; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D054368:Laxatives; D009292:Narcotic Antagonists; D009294:Narcotics; D009270:Naloxone; D008691:Methadone