A double-blind comparison of the effect of the antipsychotics haloperidol and olanzapine on sleep in mania

Moreno, R.A.; Hanna, Magdy M.; Tavares, S.M.O.; Wang, Yuan‐Pang

doi:10.1590/s0100-879x2007000300011

Cited by 19 publications

(5 citation statements)

References 30 publications

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“…These were carried out in those with schizophrenia and those with mood disorders and indicate that this medication decreases sleep onset latency and wake time after sleep onset and increases sleep efficiency, sleep quality ratings and the amount and percentage of slow-wave sleep. 178–185 Small studies also document that cloazapine decreases awakenings, and wake time after sleep onset and increases total sleep time and amount of slow-wave sleep 186–187 and that risperidone 0.5–1 mg decreases wake time after sleep onset as well as the amount of REM sleep. 188 …”

Section: The Sleep Effects Of Psychiatric Treatments;mentioning

confidence: 99%

Psychiatric Disorders and Sleep

2012

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SYNOPSIS Psychiatric disorders and sleep are related in important ways. In contrast to the longstanding view of this relationship which viewed sleep problems as symptoms of psychiatric disorders, there is growing experimental evidence that the relationship between psychiatric disorders and sleep is complex and includes bi-directional causation. In this article we provide the evidence that supports this point of view, reviewing the data on the sleep disturbances seen in patients with psychiatric disorders but also reviewing the data on the impact of sleep disturbances on psychiatric conditions. Although much has been learned about the psychiatric disorders-sleep relationship, additional research is needed to better understand these relationships. This work promises to improve our ability to understand both of these phenomena and to allow us to better treat the many patients with sleep disorders and with psychiatric disorders.

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Section: The Sleep Effects Of Psychiatric Treatments;mentioning

confidence: 99%

Psychiatric Disorders and Sleep

2012

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“…In both case 2 and 3, olanzapine was prescribed off-label at bedtime to help promote sleep. In a small double-blind, randomized, placebo-controlled trial, olanzapine has been shown to improve sleep efficiency, total sleep time, and sleep latency in patients with depression and bipolar disorder (27), superior to haloperidol in bipolar patients during manic episodes (28), and more effective than risperidone for the treatment of paradoxical insomnia (29).…”

Section: Discussionmentioning

confidence: 99%

Benefits and risks of off-label olanzapine use for symptom management in cancer patients—a case report

Dev¹,

Fortuno²,

Amaram‐Davila³

et al. 2023

Ann Palliat Med

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Background: Cancer patients often experience symptoms such as anorexia, anxiety and insomnia, which can impact their quality of life. Randomized placebo-controlled trials support prophylactic use of olanzapine for the prevention of nausea and vomiting due to moderate and high-emetic risk chemotherapy. In the setting of palliative care, olanzapine is increasingly utilized as an off-label treatment of symptoms including anorexia-cachexia, anxiety, and insomnia. The following case reports will highlight the potential benefits and risks of off-label olanzapine use for symptom management in cancer patients.Case Description: Patient 1 is a female in her 70s with stage IV infiltrating ductal carcinoma of the right breast was having trouble tolerating treatment with letrozole, palbociclib, and denosumab due to uncontrolled nausea resulting in weight loss. Her nausea was refractory to multiple anti-emetics. Low dose olanzapine (2.5 mg) prevented nausea and allowed her to tolerate treatment. Patient 2 is a male in his 50s with renal cell carcinoma, who was receiving treatment with cabozantinib, presented with uncontrolled pain improved with opioid rotation from oxycodone to morphine. He was also experiencing uncontrolled anxiety despite treatment with alprazolam. Alprazolam was weaned and replaced with olanzapine resulting in improvement of his symptoms. Patient 3 is a male in his 60s with pancreatic adenocarcinoma who presented with muscle weakness and fatigue resulting in discontinuation of gemcitabine plus cisplatin. He also had symptoms of depression, poor appetite, and sleep problems. He was prescribed short course of dexamethasone 4 mg by mouth twice daily and olanzapine 5 mg by mouth nightly to improve symptoms.One week after, he presented with confusion and workup revealed hyperammonia which was treated with lactulose, which led to the return of baseline mentation.Conclusions: Olanzapine antagonizes multiple receptors and has potential to treat a host of symptoms including nausea, anorexia, anxiety, and insomnia, but healthcare providers should be mindful of potential risks and unclear benefits for off-label indications. More research and funding are needed evaluating off-label use of olanzapine for palliation of symptoms in cancer patients who are often frail and susceptible to adverse events.

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“…Antipsychotic medications are of particular interest due to their use in the management of delirium and have been observed to have variable effects on sleep architecture. Haloperidol has been shown to increase sleep efficiency, whereas the atypical agents, olanzapine and risperidone, have the additional effect of promoting slow wave sleep[ 99 , 109 - 111 ].…”

Section: Causes Of Sleep Disturbance In the Critically Illmentioning

confidence: 99%

Sleep during and following critical illness: A narrative review

Showler¹,

Abdelhamid²,

Goldin³

et al. 2023

World J Crit Care Med

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Sleep is a complex process influenced by biological and environmental factors. Disturbances of sleep quantity and quality occur frequently in the critically ill and remain prevalent in survivors for at least 12 mo. Sleep disturbances are associated with adverse outcomes across multiple organ systems but are most strongly linked to delirium and cognitive impairment. This review will outline the predisposing and precipitating factors for sleep disturbance, categorised into patient, environmental and treatment-related factors. The objective and subjective methodologies used to quantify sleep during critical illness will be reviewed. While polysomnography remains the gold-standard, its use in the critical care setting still presents many barriers. Other methodologies are needed to better understand the pathophysiology, epidemiology and treatment of sleep disturbance in this population. Subjective outcome measures, including the Richards-Campbell Sleep Questionnaire, are still required for trials involving a greater number of patients and provide valuable insight into patients’ experiences of disturbed sleep. Finally, sleep optimisation strategies are reviewed, including intervention bundles, ambient noise and light reduction, quiet time, and the use of ear plugs and eye masks. While drugs to improve sleep are frequently prescribed to patients in the ICU, evidence supporting their effectiveness is lacking.

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A double-blind comparison of the effect of the antipsychotics haloperidol and olanzapine on sleep in mania

Cited by 19 publications

References 30 publications

Psychiatric Disorders and Sleep

Psychiatric Disorders and Sleep

Benefits and risks of off-label olanzapine use for symptom management in cancer patients—a case report

Sleep during and following critical illness: A narrative review

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