Comparative cognitive and subjective side effects of immediate-release oxycodone in healthy middle-aged and older adults.

Publication Type:

Journal Article

Source:

The journal of pain : official journal of the American Pain Society, Volume 10, Issue 10, p.1038-50 (2009)

Keywords:

2009, Administration, Oral, Adult, Age Factors, Aged, Aging, Attention, Clinical Research Division, Cognition, Cognition Disorders, Dose-Response Relationship, Drug, Drug Administration Schedule, Drug Toxicity, Female, Geriatric Assessment, Humans, Male, Memory Disorders, Memory, Short-Term, Middle Aged, Neuropsychological Tests, Oxycodone, Pain, Pain Measurement, Questionnaires, Risk Factors, Single-Blind Method, Treatment Outcome

Abstract:

This study measured the objective and subjective neurocognitive effects of a single 10-mg dose of immediate-release oxycodone in healthy, older (> 65 years), and middle-aged (35 to 55 years) adults who were not suffering from chronic or significant daily pain. Seventy-one participants completed 2 separate study days and were blind to medication condition (placebo, 10-mg oxycodone). Plasma oxycodone concentration peaked between 60 and 90 minutes postdose (P < .01) and pupil size, an indication of physiological effects of the medication, peaked at approximately 90 to 120 minutes postdose (P < .01). Significant declines in simple and sustained attention, working memory, and verbal memory were observed at 1 hour postdose compared to baseline for both age groups with a trend toward return to baseline by 5 hours postdose. For almost all cognitive measures, there were no medication by age-interaction effects, which indicates that the 2 age groups exhibited similar responses to the medication challenge. This study suggests that for healthy older adults who are not suffering from chronic pain, neurocognitive and pharmacodynamic changes in response to a 10-mg dose of immediate-release oxycodone are similar to those observed for middle-aged adults. PERSPECTIVE: Study findings indicate that the metabolism, neurocognitive effects, and physical side effects of oral oxycodone are similar for healthy middle-aged and older adults. Therefore, clinicians should not avoid prescribing oral opioids to older adults based on the belief that older adults are at higher risk for side effects than younger adults.