Amphetamines to counteract opioid-induced sedation

OBJECTIVE: To describe the data regarding the use of amphetamines and amphetamine derivatives to counteract opioid-induced sedation. SUMMARY: Sedation is a major dose-limiting adverse effect of opioid therapy for many patients. Several reports have evaluated the use of amphetamines and amphetamine derivatives, such as mazindol, dextroamphetamine, and methylphenidate, to counteract opioid-induced sedation, with limited results. CONCLUSIONS: General use of amphetamines for the treatment of opioid-induced sedation is not recommended. However, these agents may be effective for certain patients who experience dose-limiting sedation with opioids and have exhausted all other options available to manage this adverse effect More research is needed to identify appropriate candidates for therapy, the preferred amphetamine, and the optimal dose.