Improvement in intermittent claudication due to transition from long-term opioid therapy to mianserin: a case report

Abstract

We report the case of a 76-year-old man who developed intermittent claudication resulting in pain below the foot when walking. Although the pain was alleviated by opioid administration, it worsened over time. Peripheral arterial disease and lumbar spinal canal stenosis were excluded as possible causes of intermittent claudication. The presence of a positive Tinel's sign over the tarsal tunnel led to a clinical diagnosis of tarsal tunnel syndrome. Opioids and duloxetine did not improve intermittent claudication. Transition from opioids to the tetracyclic antidepressant, mianserin, improved intermittent claudication. Thus, our case suggests that intermittent claudication can be improved by transition from opioid to mianserin therapy.