Paliatívna medicína a liečba bolesti 2/2008

Confusion, delirium and hallucinations caused by treatment with morphine

Confusion, delirium and hallucinations are in general rare adverse events caused by morphine or strong opioids. However, they occur more often when used in patients with advanced cancer, especially in elderly and those repeatedly needed the doses enhancement. Mild, initial symptoms of confusion and hallucinations are possibly under diagnosed. On the other hand is it possible that some more severe symptoms are contributed wrongly to morphine when other cause exists. There is no tolerance development to hyperactive delirium, confusion, and hallucinations. Thus the dose should be decreased or opiod rotation used if there is no other obvious cause for confusion and hallucinations.

Keywords: morphine, strong opioids, delirium, confusion, hallucinations.