Assessing cognitive and psychomotor performance under long-term treatment with transdermal buprenorphine in chronic noncancer pain patients
Abstract
BACKGROUND: The therapeutic use of opioids has been associated with altered cognition and impaired psychomotor function. Several studies have demonstrated the impact of opioid therapy on psychomotor performance and cognition, but there are no data about the effect of long-term treatment with transdermal buprenorphine on driving ability. METHODS: Thirty patients suffering from chronic noncancer pain, who had been treated with stable doses of transdermal buprenorphine, included in a prospective trial and compared with 90 healthy volunteers (matched pairs). A computerized test battery, developed to assess the driving ability of traffic delinquents in Germany, was used. Attention reaction, visual orientation, motor coordination, and vigilance were evaluated. The data from 14 variables were assessed, and for each test, a relevant score was defined. As the primary end-point, the sum score of the three relevant scores was determined. A weaker statistical means to assess the patient's performance is to compare the test results to an age-independent control group. Individuals performing worse than the 16th percentile of this control group are considered to be unable to drive according to German law. RESULTS: According to tests that predict driving ability, patients receiving transdermal buprenorphine were shown to be noninferior to the control group. Driving ability, as defined as a result above the 16th percentile, did not differ significantly between the patients and the control group. CONCLUSION: Long-term use of transdermal buprenorphine for chronic noncancer pain does not impair driving ability, but because of the individual variability of test results, an individual assessment is recommended.
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High-dose opioids are linked to a worsening of cognitive functions, although not in non-opioid-naïve patients.
“However, high dose opioids are linked to a worsening of cognitive functions [61], although not in non-opioid-naïve patients [62].”
From The Efficacy of Buprenorphine in Major Depression, Treatment-Resistant Depression and Suicidal Behavior: A Systematic Review (2018) · cites this paper as [62]
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- Authors
- Dagtekin, O., Gerbershagen, H. J., Wagner, W., Petzke, F., Radbruch, L., & Sabatowski, R.
- Affiliations
- University of Cologne (DE)
- RWTH Aachen University (DE)
- Technische Universität Dresden (DE)
- Corresponding author
- Dagtekin, Oguzhan
- Wagner, Werner
- Petzke, Frank
- Venue
- Anesthesia & Analgesia
- Published
- 2007-11
- Volume
- 105
- Issue
- 5
- Pages
- 1442-1448
- ISSN
- 0003-2999 (ISSN-L)
- OpenAlex
- W2065578778
- Cited by
- 47
- References
- 38
- Citations by year
- 2026: 1 · 2024: 1 · 2022: 1 · 2021: 4 · 2020: 1 · 2019: 1 · 2018: 5 · 2017: 3 · 2016: 4 · 2015: 3 · 2014: 3 · 2013: 3 · 2012: 5
- FWCI
- 3.09
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Anesthesia & Analgesia (publishedVersion)
- PubMed (publishedVersion)
- RWTH Publications (RWTH Aachen) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Physical Sciences › Engineering › Safety, Risk, Reliability and Quality › Traffic and Road Safety
- Keywords
- transdermal buprenorphine, chronic non-cancer pain, driving ability, psychomotor performance, cognitive impairment, opioid side effects, attention, sustained attention, motor coordination, visual orientation
- MeSH terms
- Administration, Cutaneous, Adult, Aged, Automobile Driving, Buprenorphine, Chronic Disease, Cognition, Female, Humans, Long-Term Care, Male, Middle Aged, Pain, Prospective Studies, Psychomotor Performance, Reaction Time
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