Oral morphine therapy for chronic noncancer pain

Canadian Medical Association Journal 1996; 155: 200-201

Source: Moulin DE, Iezzi A, Amireh R et al: Randomised trial of oral morphine for chronic non-cancer pain. Lancet 1996; 347: 143-147

Forty-six adults referred to a multidisciplinary pain clinic in Ontario with chronic noncancer pain unresponsive to conventional treatment took part in a randomized, double-blind crossover study to compare the effect of morphine (up to 60 mg orally twice daily) with that of benztropine (up to 1 mg twice daily). Benztropine has no analgesic properties but was used as an "active placebo" to mimic the side effects of morphine. Initial and crossover phases of the study consisted of a 3-week titration period, 6 weeks of treatment with evaluation and a 2-week washout period. The morphine group experienced a significantly greater reduction in mean pain intensity than the placebo group, without cognitive impairment or significant evidence of dependence. However, there were no significant differences between the two groups with respect to psychological and functional outcomes, and the morphine therapy was associated with more frequent adverse effects than the benztropine therapy.

| CMAJ July 15, 1996 (vol 155, no 2) | International digest |