Comparative Cognitive and Subjective Side Effects of Immediate-Release Oxycodone in Healthy Middle-Aged and Older Adults

Abstract

This study measured the objective and subjective neurocognitive effects of a single 10mg dose of immediate-release oxycodone in healthy, older (>65 years) and middle age (35 -55 years) adults who were not suffering from chronic or significant daily pain. Seventy-one participants completed two separate study days and were blind to medication condition (placebo, 10 mg oxycodone). Plasma oxycodone concentration peaked between 60 and 90 min post dose (p<0.01) and pupil size, an indication of physiological effects of the medication peaked at approximately 90 to 120 min post dose (p<0.01). Significant declines in simple and sustained attention, working memory and verbal memory were observed at one hour post dose compared to baseline for both age groups with a trend toward return to baseline by five hours post dose. For almost all cognitive measures there were no medication by age interaction effects, which indicates that the two age groups exhibited a 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 age adults.Perspective-Study findings indicate that the metabolism, neurocognitive effects, and physical side effects of oral oxycodone are similar for healthy middle-age 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.

Oxycodone induced delirium and agitation in an elderly patient following total right knee arthroplasty

“…However, no recommendations are available on which opiate to change to if an ADR is suspected, because there is a possibility of mental status changes with any opioid derived narcotic pain reliever. Clinicians should be cognizant of this on a per patient basis as delirium has been tied extensively to elderly individuals [5], especially after elective orthopedic surgery [4,6].…”

“…Narcotic drugs or opioids have been attributed with psychiatric and cognitive effects and can lead to severe adverse events [5]. As a patient ages over 65, the need for elective surgeries may arise which have been associated with the onset of delirium [4,6].…”

Subjective, psychomotor, and physiological effects of oxycodone alone and in combination with ethanol in healthy volunteers

“…As determined from both pharmacokinetic and pharmacodynamics studies using oxycodone, we estimated peak effects of oxycodone to be approximately 60-120 min after ingestion (Poyhia et al 1992;Mandema et al 1996;Zacny and Gutierrez 2003;Walsh et al 2008;Zacny and Lichtor 2008;Cherrier et al 2009) and peak ethanol effects to be approximately 15-30 min post-ingestion (Holdstock and de Wit 1998;King et al 2002;Erblich et al 2003).…”

The effects of acute and chronic steady state methadone on memory retrieval in rats

“…The effects of methadone and other mu-opioid agonists, however, depend on how (i.e., acute or chronic) and when (i.e., during acquisition or before retrieval) the drug is administered, on the type of learning/memory test, and on the dose (Izquierdo 1980;Levy et al 2009;Castellano and McGaugh 1989;Spain and Newsom 1991;Cummins and Leri 2008;Djahanguiri et al 1966;Cherrier et al 2009;Coda et al 1993;Curran et al 2001;Friswell et al 2008;Kerr et al 1991;O'Neill et al 2000;Saarialho-Kere et al 1989). Therefore, it is important to make a distinction between acute and chronic administration and to compare various doses on a number of tasks.…”