Secondary mania following cancer chemotherapy with capecitabine

Garg, Harshit; Prakash, Sathya; Deb, Koushik Sinha; Chadda, Rakesh Kumar

doi:10.1136/bcr-2017-220995

Cited by 5 publications

(3 citation statements)

References 8 publications

(2 reference statements)

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“…On evaluation by psychiatry, he was noted to be delusional, grandiose, and displayed features of agitation. Similar to Garg et al, physical examination, biochemical markers and parameters, and brain imaging were unremarkable [8].…”

Section: Literature Review Of Secondary Psychotic Symptoms Postchemot...supporting

confidence: 74%

Secondary Psychosis Following Neoadjuvant AC-T Chemotherapy for Triple-Negative Breast Cancer: Case Report and Literature Review of Psychosis Postchemotherapy

Alshehri

Assiri

Alsalem

et al. 2022

Case Reports in Psychiatry

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Triple-negative breast cancer is a unique subtype among breast cancers. Management includes a neoadjuvant chemotherapy regimen. Psychiatric complications of the regimen have not been reported before. We present a case of acute psychosis after the second cycle of chemotherapy in a 42-year-old woman with triple-negative breast cancer. The patient presented with sudden irritability, agitation, disorganization in speech and behavior, and paranoia involving her coworkers conspiring against her and causing her trouble with the law for 4 days. She was in her usual state of health until after her second cycle of chemotherapy. This was the first presentation of psychotic symptoms in her life. She was conscious and oriented. There were no neurologic deficits. She denied any change in her mood and any features of hallucinations. She was uncooperative, restless, had flight of ideas, and persecutory delusions. The remainder of the examination was normal. An autoimmune process, nervous system infection, or psychosis secondary to the chemotherapy were suspected. Serum electrolytes and other biochemical parameters were normal. Imaging of the brain showed no signs of acute brain insults or intracranial metastasis. Cerebrospinal fluid analysis and culture showed no abnormality or growth. The work-up revealed that neurologic, infectious, or autoimmune causes of her psychotic symptoms were less likely. Thus, a diagnosis of psychosis secondary to chemotherapy was considered. Treatment was with paliperidone, risperidone, clonazepam, and sertraline. Over the course of treatment, she showed substantial improvement and completed all of the chemotherapy sessions without adverse effects. In summary, we report a case of a patient whose initial chemotherapy course was complicated by psychosis. Since the neurotoxic and psychiatric effects of chemotherapeutics are not yet sufficiently elucidated, our case emphasizes that early signs of behavioral changes in patients receiving chemotherapy should trigger comprehensive psychiatric evaluation and monitoring of the patient’s mental state.

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Section: Literature Review Of Secondary Psychotic Symptoms Postchemot...supporting

confidence: 74%

Secondary Psychosis Following Neoadjuvant AC-T Chemotherapy for Triple-Negative Breast Cancer: Case Report and Literature Review of Psychosis Postchemotherapy

Alshehri

Assiri

Alsalem

et al. 2022

Case Reports in Psychiatry

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“…After readjustment of antipsychotic therapy, symptoms subsided within 15 days. Table 2 [17,[81][82][83][84][85][86][87][88][89] summarizes chemotherapeutic agents associated with similar presentations.…”

Section: Chemotherapy-induced Mania: Should We Use Mood Stabilizers?mentioning

confidence: 99%

“…Medical disorders may present with psychosis first, necessitating a methodical approach to diagnosis to determine the reason. Thus, an oncologic origin, such as a steroid-producing tumor, a space-occupying brain lesion, or a paraneoplastic etiology, should be suspected if psychosis develops slowly [ 17 ]. SMI is described as schizophrenia or bipolar disorder that requires long-term therapy and results in disability or dysfunction [ 18 ].…”

Section: Manifestation Of Psychosis and Mania In Cancer Patientsmentioning

confidence: 99%

Challenges in Treating Cancer Patients With Unstable Psychiatric Disorder

et al. 2021

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In this review, we first present a case of chronic myeloid leukemia with acute psychosis, and then we will discuss the incidence of cancer in patients with psychotic disorders, the manifestations of new-onset psychosis, and the prevalence of preexisting psychosis in cancer patients, coupled with their impact on the treatment, diagnosis, and prognosis of cancer. This was a case that presented with acute psychosis and was found to have an elevated white blood cell count upon admission to an inpatient psychiatric unit. He was diagnosed with chronic myeloid leukemia and successfully managed with imatinib/dasatinib therapy. Psychiatrically, he was stabilized on two long-acting injectable medications to help maintain adherence. We were able to eliminate his active psychotic symptoms and return him to normal functioning in affect and thinking, achieving sustained compliance with treatment. We identified multiple inconsistencies in screening for cancer of all types in these patients, masking of signs and symptoms that would typically clue physicians to the presence of cancers, underreporting of symptoms, and disparate access to healthcare resources in patients with mental disorders when compared to the general population. Treatment of cancer in these patients as compared to the general population has also been shown to be incongruent, which will be elaborated upon. Psychiatric interventions, as well as supportive measures, for treating patients who are facing challenges during active cancer treatment will be discussed.

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Capecitabine/oxaliplatin

宏明¹,

ほか²

2017

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Secondary mania following cancer chemotherapy with capecitabine

Cited by 5 publications

References 8 publications

Secondary Psychosis Following Neoadjuvant AC-T Chemotherapy for Triple-Negative Breast Cancer: Case Report and Literature Review of Psychosis Postchemotherapy

Secondary Psychosis Following Neoadjuvant AC-T Chemotherapy for Triple-Negative Breast Cancer: Case Report and Literature Review of Psychosis Postchemotherapy

Challenges in Treating Cancer Patients With Unstable Psychiatric Disorder

Capecitabine/oxaliplatin

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