Management of symptoms associated with advanced cancer: olanzapine and mirtazapine. A World Health Organization project.
Advanced cancer patients are polysymptomatic and often receive multiple medications for symptom relief. Common symptoms include anorexia, weight loss, delirium and depression. Olanzapine and mirtazapine may have several advantages over older agents despite increased acquisition costs. Both medications can treat several symptoms with a low risk for drug-drug interactions and with only once- or twice-daily dosing. Drug side effects are low, compared with more conventionally used agents. The pharmacokinetics and pharmacodynamics of both agents are unique and explain many of the benefits. More research and clinical experience will be necessary to define their role in the palliation of advanced cancer.
Davis
Mellar P
MP
Harry R Horvtiz Center for Palliative Medicine, Cleveland Clinic Foundation, OH 44195, USA. davism6@ccf.org
Khawam
Elias
E
Pozuelo
Leo
L
Lagman
Ruth
R
D000928:Antidepressive Agents / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D001569:Benzodiazepines; D004347:Drug Interactions; D006801:Humans; D008803:Mianserin / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D000078785:Mirtazapine; D009369:Neoplasms / Q000150:complications* / Q000523:psychology*; D000077152:Olanzapine; D010166:Palliative Care; D010890:Pirenzepine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*
D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D001569:Benzodiazepines; D008803:Mianserin; D010890:Pirenzepine; D000078785:Mirtazapine; D000077152:Olanzapine