#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Olanzapine in oncology palliative care


Authors: Z. Šoukalová
Authors place of work: Onkologické oddělení, Nemocnice Jihlava
Published in the journal: Klin Onkol 2022; 35(4): 276-283
Category: Review
doi: https://doi.org/10.48095/ccko2022276

Summary

Background: Olanzapine is an effective antipsychotic drug used in psychiatry to treat psychoses, especially schizophrenia and schizoaffective disorders. It belongs to the 2nd generation antipsychotics, its mechanism of action ranks among multireceptor antagonists (MARTA); it affects the dopamine, serotonin, adrenaline, histamine, and muscarinic systems. The broad pharmacodynamic profile of olanzapine provides for a broad indication spectrum with a better adverse effect profile compared to conventional antipsychotics. It can be used in a number of situations to benefit cancer patients in palliative care as well as in the terminal stages of the disease. Purpose: The review article presents possible indications for olanzapine in oncological palliative care. Apart from dealing with delirium and anxiety, indications for the use of antipsychotics in palliative medicine include the management of nausea, vomiting and loss of appetite. Olanzapine is an effective antiemetic in cancer patients with tumor-induced nausea and in antiemetic regimens for chemotherapy-induced nausea and vomiting. Olanzapine is an effective treatment for delirium, as effective as haloperidol, but with a lower toxicity profile. It increases appetite and can be used with advantage in patients with anorexia and weight loss. It is possible to use its anxiolytic and mood-stabilizing effects; in many situations, it can serve well as a co-analgesic, especially in the so-called total pain. It is proven to increase the quality of life of patients with advanced cancer. Conclusion: Due to its effect, simple dosage and a good safety profile, olanzapine is a useful drug for the routine clinical practice of an oncologist – a non-psychiatrist.

Keywords:

anxiety – delirium – palliative care – Nausea – sleep disorders – anorexia – olanzapine – total pain


Zdroje

1. Fusar-Poli P, Meyer-Lindenberg A. Striatal presynaptic dopamine in schizophrenia, part II: meta-analysis of [ (18) F/ (11) C]-DOPA PET studies. Schizophr Bull 2013; 39 (1): 33–42. doi: 10.1093/schbul/sbr180.

2. Kopeček M. Aktualizované klinické a teoretické aspekty podávání antipsychotik. Klin Farmakol Farm 2012; 26 (1): 18–29.

3. Arakawa R, Takano A, Halldin C. PET technology for drug development in psychiatry. Neuropsychopharmacol Rep 2020; 40 (2): 114–121. doi: 10.1002/npr2.12084.

4. SPC Olanzapin Actavis. [online]. Dostupné z: https: // www.sukl.cz/download/spc/SPC2111.pdf.

5. Kopeček M. Klinické a teoretické aspekty podávání antipsychotik (neuroleptik). Remedia 2002; 12: 447–465.

6. Leucht S, Corves C, Arbter D et al. Second-generation versus first-generation antipsychotic drugs for schizophrenia: a meta-analysis. Lancet 2009; 373 (9657): 31–41. doi: 10.1016/S0140-6736 (08) 61764-X.

7. Navari RM, Gray SE, Kerr AC. Olanzapine versus aprepitant for the prevention of chemotherapy-induced nausea and vomiting: a randomized phase III trial. J Support Oncol 2011; 9 (5): 188–195. doi: 10.1016/j.suponc.2011.05.002.

8. Hashimoto H, Abe M, Tokuyama O et al. Olanzapine 5 mg plus standard antiemetic therapy for the prevention of chemotherapy-induced nausea and vomiting (J-FORCE): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Oncol 2020; 21 (2): 242–249. doi: 10.1016/S1470-2045 (19) 30678-3.

9. Navari RM. A placebo controlled, randomized, double-blinded trial of olanzapine for the treatment of chronic nausea and/or vomiting, unrelated to chemotherapy/radiation. J Clin Oncol 2019; 37 (31 Suppl): 118.

10. Kozák J, Lejčko J, Vrba I. Opioidy. Praha: Mladá fronta 2018.

11. Hardy J, Daly S, McQuade B et al. A double-blind, randomised, parallel group, multinational, multicentre study comparing a single dose of ondansetron 24 mg p. o. with placebo and metoclopramide 10 mg t.d.s. p. o. in the treatment of opioid-induced nausea and emesis in cancer patients. Support Care Cancer 2002; 10 (3): 231–236. doi: 10.1007/s00520-001-0332-1.

12. Torigoe K, Nakahara K, Rahmadi M et al. Usefulness of olanzapine as an adjunct to opioid treatment and for the treatment of neuropathic pain. Anesthesiology 2012; 116 (1): 159–169. doi: 10.1097/ALN.0b013e31823c7 e56.

13. Sláma O, Kabelka L, Vorlíček J. Paliativní medicína pro praxi. Praha: Galén 2011.

14. Yanai K, Tashiro M. The physiological and pathophysiological roles of neuronal histamine: an insight from human positron emission tomography studies. Pharmacol Ther 2007; 113 (1): 1–15. doi: 10.1016/ j.pharmthera.2006.06.008.

15. Attia E, Steinglass JE, Walsh BT et al. Olanzapine versus placebo in adult outpatients with anorexia nervosa: a randomized clinical trial. Am J Psychiatry 2019; 176 (6): 449–456. doi: 10.1176/appi.ajp.2018.18101125.

16. Okamoto H, Shono K, Nozaki-Taguchi N. Low-dose of olanzapine has ameliorating effects on cancer-related anorexia. Cancer Manag Res 2019; 11: 2233–2239. doi: 10.2147/CMAR.S191330.

17. Doporučení ČSPM k léčbě symptomů v paliativní péči Česká společnost paliativní medicíny České lékařské společnosti Jana Evangelisty Purkyně. [online]. Dostupné z: https: //docplayer.cz/198016335-Doporuceni-cspm-k-lecbe-symptomu-v-paliativni-peci-ceska-spolecnost-paliativni-mediciny-ceske-lekarske-spolecnosti-jana-evangelisty-purkyne.html.

18. Boettger S, Jenewein J, Breitbart W. Haloperidol, risperidone, olanzapine and aripiprazole in the management of delirium: a comparison of efficacy, safety, and side effects. Palliat Support Care 2015; 13 (4): 1079–1085. doi: 10.1017/S1478951514001059.

19. Kishi T, Hirota T, Matsunaga S et al. Antipsychotic medications for the treatment of delirium: a systematic review and meta-analysis of randomised controlled trials. J Neurol Neurosurg Psychiatry 2016; 87 (7): 767–774. doi: 10.1136/jnnp-2015-311049.

20. van der Vorst MJDL, Neefjes ECW, Boddaert MSA et al. Olanzapine versus haloperidol for treatment of delirium in patients with advanced cancer: a phase III randomized clinical trial. Oncologist 2020; 25 (3): e570–e577. doi: 10.1634/theoncologist.2019-0470.

21. Yoon HJ, Park KM, Choi WJ et al. Efficacy and safety of haloperidol versus atypical antipsychotic medications in the treatment of delirium. BMC Psychiatry 2013; 13: 240. doi: 10.1186/1471-244X-13-240.

22. lsayem A, Bush SH, Munsell MF et al. Subcutaneous olanzapine for hyperactive or mixed delirium in patients with advanced cancer: a preliminary study. J Pain Symptom Manage 2010; 40 (5): 774–782. doi: 10.1016/j.jpainsymman.2010.02.017.

23. Chan EW, Taylor DM, Knott JC et al. Intravenous droperidol or olanzapine as an adjunct to midazolam for the acutely agitated patient: a multicenter, ran­domized, double-blind, placebo-controlled clinical trial. Ann Emerg Med 2013; 61 (1): 72–81. doi: 10.1016/j.annemergmed.2012.07.118.

24. Temmingh H, Stein DJ. Anxiety in patients with schizophrenia: epidemiology and management. CNS Drugs 2015; 29 (10): 819–832. doi: 10.1007/s40263-015-0282-7.

25. Bowden CL. Atypical antipsychotic augmentation of mood stabilizer therapy in bipolar disorder. J Clin Psychiatry 2005; 66 (Suppl 3): 12–19.

26. Kec D, Ludka O, Hamerníková V et al. Současné trendy v léčbě a dia­gnostice chronické nespavosti. Čes Slov Psychiat 2020; 116 (3): 139–149.

27. Basire S. Psychotropic drug directory. HealthComm UK Ltd.: Aberdeen 2010: 202–203.

Štítky
Paediatric clinical oncology Surgery Clinical oncology

Článok vyšiel v časopise

Clinical Oncology

Číslo 4

2022 Číslo 4
Najčítanejšie tento týždeň
Najčítanejšie v tomto čísle
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#