Use of psychotropics in cancer patients

Goldberg, Richard J.; Cullen, Leah Oseas

doi:10.1016/s0033-3182(86)72619-4

Cited by 10 publications

(3 citation statements)

References 55 publications

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“…osteo-arthritic disorders, AIDS, and other slowly progressive illnesses with inevi table fatal termination. The use of anxioly tics can be an important adjuvant therapy in these conditions and also to allay the anxiety caused by many of the treatments used, par ticularly in malignant disease [66].…”

Section: Chronic Illnessesmentioning

confidence: 99%

Use of Anti-Anxiety Drugs in the Medically Ill

Wheatley¹

1988

Psychother Psychosom

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The Stress Clinic at the Maudsley Hospital investigates anxiety due to stress and its pharmacological treatment. Nine stress areas are investigated and their relative severities estimated: social habits, social relationships, life events, psychiatric morbidity, sexual stresses, sleep, stress in old age, menstrual stresses and stress and the heart. From the results a Stress Profile can be constructed for each patient to compare the importance of these different stresses and this can also be used as a measure of change in response to treatment. The benzodiazepine (BZD) anxiolytics can be divided into two groups according to duration of action, medium (8–12 h) and long (30–100 h). Short-acting BZD drugs are particularly useful for situational anxiety, when treatment can be interrupted over night and at weekends. To overcome problems of dependence, withdrawal effects, and daytime side-effects, new non-BZD anxiolytics have been developed: buspirone, alpidem and suriclone. These may be particularly useful for long-term treatment of anxiety. Another alternative is the use of adrenergic beta-blocking drugs of which propranolol and betaxolol have been used in the Clinic, because of their relatively high concentration in the brain when taken orally. Anxiety accompanying coronary heart disease and hypertension can be controlled with anxiolytic drugs and other illnesses with an anxiety component are: sexual disorders, menstrual disorders, asthma, gastro-intestinal conditions, dermatological conditions and chronic illnesses such as malignancy and AIDS. Lack of sleep is a subtle form of stress exerting an adverse effect in almost every illness known to man. BZD hypnotics can be divided into four groups: ultra-short-acting (3–4 h), short-acting (5–6 h), medium-acting (7–8 h) and long-acting (9–12 h). Depending on the nature of the insomnia, ultra-short-acting and short-acting BZD are particularly convenient with minimal disadvantages. Nevertheless, new non-BZD hypnotics are also being developed, i.e. zolpidem and zopiclone. These drugs are relatively short-acting and of equivalent potency to the BZD without problems of dependence etc. Anxiety, as either cause or effect, accompanies many medical illnesses and the use of anti-anxiety drugs as concomitant therapy can both reduce morbidity and improve prognosis.

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Section: Chronic Illnessesmentioning

confidence: 99%

Use of Anti-Anxiety Drugs in the Medically Ill

Wheatley¹

1988

Psychother Psychosom

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“…Prochlor perazine is the most frequently used agent for this indication, but the use of intrave nous haloperidol and chlorpromazine is be coming more common, especially on oncol ogy services [74], All antipsychotics, except thioridazine, have antiemetic properties. Chlorpromazine has also been used in the treatment of intractable hiccoughs.…”

Section: Nonpsychiatric Usesmentioning

confidence: 99%

“…Some work has been done regarding the use of antipsychotics in the augmentation of analgesia [75], though controlled studies have not confirmed their efficacy [76], Antipsychotics are generally thought to have a synergistic effect with narcotics, although promethazine and fluphenazine may act as antianalgesics [5,9], Metoclopramide has gained wide use in gastrointestinal motility disorders, as well as for vomiting secondary to cancer chemotherapy [74], This agent blocks dopamine recep tors and has the potential for causing both acute and delayed extrapyramidal syn dromes. Thus, there is a risk of the develop ment of tardive dyskinesia in patients chron ically treated with metoclopramide.…”

Section: Nonpsychiatric Usesmentioning

confidence: 99%

Antipsychotic Use in the Medically Ill

Silver¹,

Simpson²

1988

Psychother Psychosom

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Antipsychotics are of use in a variety of medical settings. They can be used to treat organic mental disorders resulting from the medical illness and its therapy, as well as to control the symptoms of coexisting psychiatric conditions. Antipsychotics also have a variety of nonpsychiatric applications. This paper will review these uses of antipsychotic agents and how their administration must be modified in the medically ill.

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Prevalence of Psychotropic Polypharmacy and Associated Healthcare Resource Utilization during Initial Phase of Care among Adults with Cancer in USA

Aroke

Vyas

Buchanan

et al. 2019

Drugs - Real World Outcomes

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Background The use of psychotropic medications is not uncommon among patients with newly diagnosed cancer. However, the impact of psychotropic polypharmacy on healthcare utilization during the initial phase of cancer care is largely unknown. Methods We used a claims database to identify adults with incident breast, prostate, lung, and colorectal cancers diagnosed during 2011–12. Psychotropic polypharmacy was defined as concurrent use of two or more psychotropic medication classes for at least 90 days. A multivariable logistic regression was performed to identify significant predictors of psychotropic polypharmacy. Multivariable Poisson and negative binomial regressions were used to assess the associations between psychotropic polypharmacy and healthcare utilization. Results Among 5604 patients included in the study, 52.6% had breast cancer, 30.6% had prostate cancer, 11.4% had colorectal cancer, and 5.5% had lung cancer. During the year following incident cancer diagnosis, psychotropic polypharmacy was reported in 7.4% of patients, with the highest prevalence among patients with lung cancer (14.4%). Compared with patients without psychotropic polypharmacy during the initial phase of care, patients with newly diagnosed cancer with psychotropic polypharmacy had a 30% higher rate of physician office visits, an 18% higher rate of hospitalization, and a 30% higher rate of outpatient visits. The rate of emergency room visits was similar between the two groups. Conclusion Psychotropic polypharmacy during the initial phase of cancer care was associated with significantly increased healthcare resource utilization, and the proportion of patients receiving psychotropic polypharmacy differed by type of cancer. Impact Findings emphasize the importance of evidence-based psychotropic prescribing and close surveillance of events causing increased healthcare utilization among patients with cancer receiving psychotropic polypharmacy. Electronic supplementary material The online version of this article (10.1007/s40801-019-0153-5) contains supplementary material, which is available to authorized users.

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Use of psychotropics in cancer patients

Cited by 10 publications

References 55 publications

Use of Anti-Anxiety Drugs in the Medically Ill

Use of Anti-Anxiety Drugs in the Medically Ill

Antipsychotic Use in the Medically Ill

Prevalence of Psychotropic Polypharmacy and Associated Healthcare Resource Utilization during Initial Phase of Care among Adults with Cancer in USA

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