title: Chemotherapeutic drugs that penetrate the blood-brain barrier affect the development of hyperactive delirium in cancer patients.
abstract: OBJECTIVE
  Delirium is a frequently encountered psychiatric disease in terminal cancer patients. However, the mechanism of delirium is unclear. The aim of our study was to investigate the relationship between administration of chemotherapy drugs that penetrate the blood-brain barrier (BBB) and the development of delirium in cancer patients.
  
  
  METHODS
  We retrospectively analyzed 166 cancer patients (97 males, 69 females) continuously who died between September of 2007 and January of 2010 using a review of medical charts. Multiple logistic regression analysis was employed to investigate the effects of antineoplastic drugs penetrating the BBB on development of delirium in cancer patients with control for other risk factors.
  
  
  RESULTS
  In multivariate analysis, antineoplastic drugs that penetrated the BBB were significantly associated with development of delirium (OR = 18.92, CI 95 = 1.08-333.04, p < 0.001).
  
  
  CONCLUSIONS
  The use of chemotherapy drugs that penetrate the BBB may be a risk factor for delirium. This information may allow palliative care doctors and medical oncologists to predict which patients are at increased risk for delirium.
authors: Department of Medical Oncology,Division of Psychosomatic Medicine,Kinki University Faculty of Medicine,Osaka,Japan.
authors: Hiromichi
authors: H
authors: Matsuoka
authors: Department of Stress Sciences and Psychosomatic Medicine,Graduate School of Medicine,The University of Tokyo,Tokyo,Japan.
authors: Kazuhiro
authors: K
authors: Yoshiuchi
authors: Department of Medical Oncology,Division of Psychosomatic Medicine,Kinki University Faculty of Medicine,Osaka,Japan.
authors: Atsuko
authors: A
authors: Koyama
authors: Department of Palliative Care Medicine,Sakai Hospital,Kinki University Faculty of Medicine,Osaka,Japan.
authors: Masatomo
authors: M
authors: Otsuka
authors: Department of Medical Oncology,Kinki University Faculty of Medicine,Osaka,Japan.
authors: Kazuhiko
authors: K
authors: Nakagawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001812:Blood-Brain Barrier / Q000502:physiology; D003693:Delirium / Q000188:drug therapy / Q000517:prevention & control*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D012189:Retrospective Studies; D013727:Terminal Care / Q000379:methods*
chemical_list: D000970:Antineoplastic Agents
keywords: Blood–brain barrier; Cancer patients; Chemotherapeutic drugs; Delirium; P glycoprotein