Why does morphine cause hallucinations

However, if the cause of the pain is still there, most people find they need to carry on taking it. Morphine is very good for some sorts of pain but other pain needs different painkillers. You may need to take several different types of medicine to manage your pain. Morphine belongs to a group of painkillers called opioids. Morphine is the most commonly used opioid, but there are also several others, for example, oxycodone or fentanyl.

Sometimes it is necessary to switch from one strong painkiller to another. Some pain, for example, nerve pain shooting or stabbing pain , may need a different sort of painkiller to relieve it.

Your doctor will be closely monitoring how you are getting on and may need to add in other medication from time to time. There are many reasons for people to be breathless but from time to time the best drug to use for this symptom is morphine. It reduces the feeling of breathlessness that you have without removing the real cause.

Many people think that morphine is only given near the end of life; this is not true. You are given morphine to relieve strong pain. If you have any doubts at all then just ask. If you have benefited from this information and would like to share it with others, then please do — we want more people to feel comfortable facing the issue of palliative care.

For instance, the authors said, some reports place the incidence of hallucination among those with Parkinson disease as high as Ultimately, the authors said, OIH should be diagnosed based on clinical judgment rather than any specific test result. Several treatment options exist, the simplest of which is discontinuing the opioid treatment.

If this is not an option, providers can consider decreasing the dosage, rotating the opioids, altering the route of administration, or treating the patient with an opioid antagonist. The article also includes an infographic that outlined other adverse effects of opioids.

An accompanying editorial noted that another hurdle to measuring the true impact of OIH is that some patients seek out opioids for their hallucinatory effects. It is currently difficult to discern the risk factors for OIH, the authors noted, but they posited that anonymous surveys could add to understanding of the problem.

It usually lasts about two to three days. Fatigue Nausea This may occur with the drowsiness. It too tends to subside after a few days, as the body gets used to the medication or increased dosage. Constipation Opioids generally slow the movement of the bowels. Confusion or hallucinations Opioids may cause, or contribute to, confusion or hallucinations.

Back to Index. This article has been cited by other articles in PMC. Abstract Palliation of pain with morphine in cancer patients can be complicated by adverse effects.

Case presentation A year-old British Caucasian gentleman, had been diagnosed with prostate cancer one year previously and was on hormone therapy. Discussion This case illustrates the potential for morphine to cause intolerable side-effects which can be resolved by a switch to an alternative opioid. Table 1 Co-morbidities that cause cognitive impairment and hallucinations.

Metabolic Hypoxia, hypercalcaemia, hyponatraemia, renal failure, liver failure, dehydration Drug-induced Opioids, benzodiazepines, tricyclics, corticosteroids, chemotherapy, drug withdrawal Recreational drugs Including alcohol and alcohol withdrawal Infection Particularly Urinary Tract Infection in the elderly CNS Cerebral metastases, Leptomeningeal metastases, cerebrovascular incident, head injury Terminal phase Pre-terminal agitation is a recognised phenomenon. Open in a separate window.

The evidence for opioid switching A report of five cases by Galer et al , demonstrated the inter-individual variability in response to different opioids [ 4 ]. They suggested that a person's response to opioids is dependent on a number of variables: 1 Pain characteristics eg. Pain characteristics It is universally acknowledged that the analgesia needs to target the pain syndrome. Drug characteristics The metabolism of morphine is via the UGT uridine-diphosphoglyceryl transferase system in the liver where the active metabolites M6G morphine 6-glucuronide and M3G morphine 3-glucuronide are produced.

Individual characteristics Riley et al conducted a retrospective study which aimed to identify individual characteristics including haematological and biochemical parameters that could predict morphine intolerance and the need for opioid switching [ 7 ].

Oxycodone as the second-line opioid Cairns reviewed the studies evaluating the use of oxycodone compared with morphine and concluded that the analgesic effects were comparable but that a switch to oxycodone should be considered in patients experiencing intolerable side-effects such as hallucinations [ 9 ]. Consent Written informed consent was obtained from the patient for publication of this case report. Competing interests The authors declare that they have no competing interests.

Acknowledgements The authors are grateful to the patient and his family for permission to use his case in this paper. Strategies to manage the adverse effects of oral morphine: an evidence-based report. J Clin Oncol. Changing pattern of agitated impaired mental state in patients with advanced cancer: association with cognitive monitoring, hydration and opioid rotation.

J Pain Symptom Manage. New York: Oxford University Press; From opioid analgesic therapy; pp. Individual variability in the response to different opioids: report of five cases. Opioid rotation for toxicity reduction in terminal cancer patients. Clinical pharmacology and pharmacotherapy of opioid switching in cancer patients. A retrospective study of the association between haematological and biochemical parameters and morphine intolerance in patients with cancer pain.

Palliat Med. Attenuation of morphine-induced delirium in palliative care by substitution with infusion of oxycodone. The use of oxycodone in cancer-related pain: a literature review. Int J Palliat Nurs. No pain relief from morphine? Individual variation in sensitivity to morphine and the need to switch to an alternative opioid in cancer patients.

Support Care Cancer. Opioid switching from morphine to transdermal fentanyl for toxicity reduction in palliative care. Opioid rotation in the management of refractory cancer pain. Support Center Support Center. External link.

Please review our privacy policy. Opioids, benzodiazepines, tricyclics, corticosteroids, chemotherapy, drug withdrawal. Cerebral metastases, Leptomeningeal metastases, cerebrovascular incident, head injury.