Am J Hosp Palliat Care. 2009 Dec-2010 Jan;26(6):470-3. Epub 2009 Aug 7.

Buprenorphine for neuropathic pain--targeting hyperalgesia.

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Division of Solid Tumor, Harry R. Horvitz Center for Palliative Medicine, The Cleveland Clinic, Taussig Cancer Center, Cleveland, Ohio, USA.

Abstract

Opioids are well known to relieve severe, acute, and chronic nociceptive pain, but neuropathic pain shows a relatively poor response to opioids. Buprenorphine, a partial mu and ORL-1-receptor agonist, kappa-delta receptor antagonist, interacts with different G proteins than potent mu agonists and hence is not cross-tolerant to standard opioids. Buprenorphine blocks central sensitization (hyperalgesia) that is commonly found with neuropathic pain. We present a patient with neuropathic pain and tactile allodynia in which buprenorphine alleviated the hyperalgesia to a greater extent than pain severity. We found buprenorphine to be effective in reducing hypersensitivity in neuropathic pain when pure mu agonists fail to produce a response or in individuals who are intolerant to pure mu agonists.

PMID:: 19666890; [PubMed - indexed for MEDLINE]

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