Does an Antipsychotic Hold the Key to Nausea Treatment in Cancer Patients? A Review on the Anti-Nausea Effects of Olanzapine in Oncology

Abstract

Olanzapine is an antipsychotic and has increasingly become a reliable option in treating cancer-associated nausea and vomiting, especially in cases involving use of high-emetic risk chemotherapy agents. How nausea and vomiting occur in this context is explored, along with the mechanism of action of olanzapine and its beneficial as well as adverse effects. Analyzing sources implicated in understanding olanzapine's role in cancer treatment, this review notes the harms associated with nausea and vomiting induced by chemotherapy and radiation therapy (CINV and RINV, respectively), as well as evidence to support the use of olanzapine over options such as dexamethasone and aprepitant. How nausea is caused by anticancer therapy via stimulation of the chemoreceptor trigger zone is explained. To familiarize readers with recommendations from various guidelines, levels of emetic risk are defined, and examples are given to identify which chemotherapy agents fit into these levels. The mechanism of action of olanzapine is explained, in terms of its effects on receptors, its targeted areas in the brain, and suggestions for administration times to avoid sedation. Olanzapine's beneficial effects in terms of quality of life, mental health benefits, and costeffectiveness are suggested, along with adverse effects such as somnolence, weight gain, and QT prolongation.