2020 Volume 27 Issue 4 Pages 323-326
A woman in her 20s underwent a radical surgery for peritoneal metastasis of appendix cancer; there was no apparent sign of recurrence at postoperative 28-month follow-up. She was prescribed oral fentanyl (OF), but the frequency of its administration eventually increased to eight or more times a day. Since an excessive demand for the drug and suicidal tendencies were observed in the patient, the drug dosage was reduced to 1,800 µg/day. However, her demand for OF made it difficult to further reduce the dosage, and she was referred to our hospital. After admission to the psychiatric ward, the OF was replaced with 10 mg/day of methadone. Although she continued to demand OF initially, the demand decreased gradually. Thereafter, methadone was replaced with buprenorphine patches on the 15th day of hospitalization, and opioid use was completely discontinued on the 25th day. No physical withdrawal symptoms were observed. To achieve discontinuation of OF, the switch to methadone and buprenorphine was effective.
