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F Coluzzi, D Billeci, M Maggi, G Corona
PURPOSE: The use of opioids in patients with chronic non-cancer pain is common and can be associated with opioid-induced androgen deficiency (OPIAD) in men. This review aims to evaluate the current literature regarding the prevalence, clinical consequence and management of OPIAD. METHODS: A database search was performed in Medline, Embase and Cochrane using terms such as "analgesics", "opioids" and "testosterone". Relevant literature from January 1969 to March 2018 was evaluated...
December 2018: Journal of Endocrinological Investigation
Alan Hsieh, Lorenzo DiGiorgio, Mary Fakunle, Hossein Sadeghi-Nejad
INTRODUCTION: Over the last several decades, the opioid epidemic has become a national crisis, largely spurred by the spike in the use of prescription painkillers. With the epidemic came a concomitant rise in the incidence of opioid-induced androgen deficiency (OPIAD). Although OPIAD can significantly impact male sexual function and quality of life, it is an overlooked and poorly understood clinical entity that requires more attention from healthcare providers. AIM: The objectives of the current review are to highlight the increasing incidence of OPIAD and the importance of an integrated, multidisciplinary approach to identify and treat patients with the condition...
October 2018: Sexual Medicine Reviews
Raquel Ajo, Ana Segura, Laura Mira, María-Del-Mar Inda, Rocío Alfayate, Angel Sánchez-Barbie, César Margarit, Ana M Peiró
BACKGROUND: Opioids are an effective treatment for chronic non-malignant pain (CNP). Long-term use risks and side effects such as opioid-induced androgen deficiency (OPIAD) exist. This could be measured by saliva testosterone (Sal-T). OBJECTIVES: To evaluate OPIAD in long-term opioid use in CNP patients. METHODS: A cross-sectional study included CNP male outpatients under opioid treatment. Total-Testosterone (Total-T), Free-Testosterone (Free-T), Bio-Testosterone (Bio-T) and Sal-T were measured...
March 2017: Aging Male: the Official Journal of the International Society for the Study of the Aging Male
Timothy K O'Rourke, Matthew S Wosnitzer
Opioid-induced androgen deficiency (OPIAD) was initially recognized as a possible consequence of opioid use roughly four decades ago. Long-acting opioid use carries risks of addiction, tolerance, and systemic side effects including hypogonadotropic hypogonadism with consequent testosterone depletion leading to multiple central and peripheral effects. Hypogonadism is induced through direct inhibitory action of opioids on receptors within the hypothalamic-pituitary-gonadal (HPG) and hypothalamic-pituitary-adrenal (HPA) axes as well as testosterone production within the testes...
October 2016: Current Urology Reports
Jeffrey A Gudin, Adam Laitman, Srinivas Nalamachu
OBJECTIVE: Millions of patients continue to require opioid analgesics for control of moderate to severe chronic pain, which is a disease that affects more Americans than cancer, heart disease, and diabetes combined. Common opioid adverse effects include constipation, sedation, and nausea. A lesser-known sequelae is opioid induced androgen deficiency (OPIAD). The objective of this review was to better characterize the effects of opioids on the endocrine system. METHODS: Published data were evaluated to identify links between opioid use and hypogonadism, as well as to describe proposed physiological mechanisms...
October 2015: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Gary Eichenbaum, Karin Göhler, Mila Etropolski, Ilona Steigerwald, Joseph Pergolizzi, Myoung Kim, Gary Vorsanger
OBJECTIVES: Opioid-induced androgen deficiency (OPIAD) affects patients treated with opioid analgesics. The norepinephrine reuptake inhibitor (NRI) and µ-opioid receptor (MOR) agonist activities of tapentadol may result in tapentadol having less effect on serum androgen concentrations than analgesics acting through the MOR alone, such as morphine and oxycodone. The objectives of this publication are to 1) evaluate the effects of tapentadol (NUCYNTA and NUCYNTA extended release [ER]) on sex hormone concentrations in healthy male volunteers (vs placebo and morphine) and patients with osteoarthritis (vs placebo and oxycodone), and 2) present a mechanistic hypothesis explaining how the combined MOR agonist and NRI activities of tapentadol may result in less impact on androgen concentrations...
May 2015: Journal of Opioid Management
Allen D Seftel
No abstract text is available yet for this article.
January 2013: Journal of Urology
Howard S Smith, Jennifer A Elliott
Opioid therapy is one of the most effective forms of analgesia currently in use. In the past few decades, the use of opioids as a long-term treatment for chronic pain has increased dramatically. Accompanying this upsurge in the use of long-term opioid therapy has been an increase in the occurrence of opioid associated endocrinopathy, most commonly manifested as an androgen deficiency and therefore referred to as opioid associated androgen deficiency (OPIAD). This syndrome is characterized by the presence of inappropriately low levels of gonadotropins (follicle stimulating hormone and luteinizing hormone) leading to inadequate production of sex hormones, particularly testosterone...
July 2012: Pain Physician
Jennifer A Elliott, Erica Horton, Eugene E Fibuch
The negative effects of long-term opioid administration on the body's endocrine system have been known for decades. These effects have been observed and studied with the use of intrathecal opioids and in heroin addicts. However, they have also been noted to occur with the use of oral opioids, especially in those patients who require chronic opioids for the management of nonmalignant and cancer-associated pain. Epidemiologic data in recent years suggest that up to five million men with chronic nonmalignant pain suffer from opioid-induced androgen deficiency (OPIAD) in the United States...
March 2011: Journal of Opioid Management
Harry W Daniell, Robin Lentz, Norman A Mazer
UNLABELLED: We conducted a 24-week open-label pilot study of testosterone (T) patch therapy in 23 men with opioid-induced androgen deficiency (OPIAD). The T dosage was 5 mg/day for the first 12 weeks and 7.5 mg/day for the second 12 weeks. Seven subjects discontinued prematurely: 4 for noncompliance, 2 for skin irritation and 1 for hepatitis C treatment. In the "completers" population (n = 16), mean (SD) free T levels (normal range 52 to 280 pg/mL) were 28.5 (18.6) pg/mL at baseline, 72...
March 2006: Journal of Pain: Official Journal of the American Pain Society
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