title: Use of olanzapine for the relief of nausea and vomiting in patients with advanced cancer: a multicenter survey in Japan.
abstract: Nausea and vomiting are among the most common and distressing symptoms in patients with advanced cancer. Olanzapine, an antipsychotic agent, is known to have an affinity for multiple neurotransmitter receptors. Previous studies have reported olanzapine to be efficacious in the treatment of nausea and vomiting. Although it has been administered at a number of facilities, its applicability to treat nausea and vomiting in patients with advanced cancer is poorly understood. We investigated the use of olanzapine for nausea and vomiting in patients with advanced cancer at multiple centers. This retrospective study was carried out at seven palliative care units and three facilities with palliative care teams in Japan from 2013 to 2015. The dosage of olanzapine, treatment duration, and duration from initial use until death were collected from the medical records. One hundred and eight patients met our inclusion criteria. The average dose of olanzapine was 3.6 mg (2.5 mg, n = 61; 5 mg, n = 46; 10 mg, n = 1) and average treatment duration was 18.7 days. The average duration from initial use until death was 39.0 days. There were no differences in the duration of administration until death between olanzapine doses (2.5 and 5 mg). Our results suggest that olanzapine have been used in patients with poor prognoses for nausea and vomiting in patients with advanced cancer. Conducting a prospective trial would further yield promising results.
authors.affiliation: Department of Palliative Care Unit, JCHO Tokyo Shinjuku Medical Center, 5-1 Tsukudo-cyo, Shinjuku, Tokyo, 162-0815, Japan. kankannjp@yahoo.co.jp.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kaneishi
authors.affiliation: Department of Palliative Care, Shimada Hospital, Fukuoka, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Nishimura
authors.affiliation: Department of gastroenterological medicine, Tokyo Rinkai Hospital, Tokyo, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Sakurai
authors.affiliation: Seirei Hospice, Seirei Mikatahara General Hospital, Hamamatsu, Japan.
authors.forename: Kengo
authors.initials: K
authors.lastname: Imai
authors.affiliation: Hospice, Medical Corporation Junkei-kai Sotoasahikawa Hospital, Akita, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Matsuo
authors.affiliation: Department of Palliative Care, Japanese Red Cross Medical Center, Tokyo, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Takahashi
authors.affiliation: Department of Palliative Medicine, Showa University Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Okamoto
authors.affiliation: Department of Palliative Medicine, Shizuoka Saiseikai General Hospital, Shizuoka, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Suga
authors.affiliation: Department of Palliative Care, Nomura Hospital, Tokyo, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Sano
authors.affiliation: Department of Palliative Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Isseki
authors.initials: I
authors.lastname: Maeda
authors.affiliation: Department of Surgery and Palliative Care Team, Koto Hospital, Tokyo, Japan.
authors.forename: Haruhiro
authors.initials: H
authors.lastname: Nishina
authors.affiliation: Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Takuhiro
authors.initials: T
authors.lastname: Yamaguchi
authors.affiliation: Palliative and Supportive care Division, Seirei Mikatahara Hospital, Hamamatsu, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Morita
authors.affiliation: Department of Palliative Medicine, Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Iwase
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000932:Antiemetics / Q000008:administration & dosage*; D000970:Antineoplastic Agents / Q000009:adverse effects; D014150:Antipsychotic Agents / Q000008:administration & dosage; D001569:Benzodiazepines / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000188:drug therapy*; D009369:Neoplasms / Q000188:drug therapy; D000077152:Olanzapine; D010166:Palliative Care / Q000379:methods; D000070659:Patient Comfort; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014839:Vomiting / Q000188:drug therapy*
chemical_list: D000932:Antiemetics; D000970:Antineoplastic Agents; D014150:Antipsychotic Agents; D001569:Benzodiazepines; D000077152:Olanzapine
keywords: Cancer; Nausea; Olanzapine; Palliative care; Vomiting
references.citation: J Pain Symptom Manage. 2010 Apr;39(4):756-67
references.pmid: 20413062
references.citation: J Pain Symptom Manage. 2003 Jun;25(6):578-82
references.pmid: 12782438
references.citation: J Pain Symptom Manage. 2012 Oct;44(4):604-7
references.pmid: 22771132
references.citation: Support Care Cancer. 2014 Apr;22(4):1143-51
references.pmid: 24522741
references.citation: J Pain Symptom Manage. 2002 Jun;23 (6):526-32
references.pmid: 12067777
references.citation: Clin Interv Aging. 2011;6:243-59
references.pmid: 21966219
references.citation: Clin Pharmacokinet. 1999 Sep;37(3):177-93
references.pmid: 10511917