Chemotherapeutic drugs that penetrate the blood–brain barrier affect the development of hyperactive delirium in cancer patients

Matsuoka, Hiromichi; Yoshiuchi, Kazuhiro; Koyama, Atsuko; Otsuka, Masatomo; Nakagawa, Kazuhiko

doi:10.1017/s1478951514000765

Cited by 25 publications

(50 citation statements)

References 30 publications

(31 reference statements)

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“…The association between long duration of cancer treatment and AMD may be understandable, given that cancer chemotherapy [65], radiotherapy [66], or surgical treatment of carcinomas such as breast cancer [67,68], are associated with anxiety or depression, of which chemotherapy and radiotherapy are administered over a period of time. So also, is the possibility of developing delirium from prolonged exposure to cancer treatment and possible adverse effects of drug/drug interaction [69].…”

Section: Discussionmentioning

confidence: 99%

Twelve-Month Prevalence of Psychiatric Morbidity in Cancer Patients in a Nigerian Oncology Centre

Lasebikan¹,

Fakunle²,

Lasebikan³

et al. 2020

Preprint

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Background Cancer is a leading cause of mortality worldwide and is associated with a wide range of psychiatric morbidity.Methods In this descriptive study, 130 patients with different types of cancer were interviewed. Information on sociodemographic characteristics, medical comorbidity, stage of cancer, duration of treatment was obtained. Psychological distress was assessed using the GHQ-12, and psychosocial distress with the Distress Thermometer (DT). The MINI was used to establish the presence or absence of any psychiatric diagnosis, including any substance use disorder. Information on receipt of formal psychiatric treatment was also obtained. Associated factors and predictors of “Any Mental Disorder” (AMD) were determined. Analysis was carried out using SPSS 20.0 Results Prevalence of psychological distress (GHQ score > 2) was 63.8%, psychosocial distress (DT score > 3) (60.8%), adjustment disorder (20.0%), anxiety y disorder (18.5%), major depression (15.4%), delirium (6.9%), psychosis (2.3%), mania (0.8%), 12-month alcohol use disorder (3.8%), 12-month tobacco use disorder (0.8%), 12-month opioid use disorder (26.9%) and 12 month cannabis use disorder (0.8)%. In all, 66.9% had AMD. The most common medical comorbidity was hypertension (36.2%) and diabetes (23.1%). Predictors of AMD were: Predictors of AMD were: duration of cancer treatment above 6 months OR = 2.66, 95% CI (1.17-6.05), DT score > 3 OR = 2.78, 95% CI (1.24-6.21) and the presence of any medical comorbidity OR = 2.29, 95% CI (1.02-5.14).Conclusion Cancer is associated with significant psychiatric morbidity, necessitating a collaborative Consultation Liaison Psychiatric service in cancer care.

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Section: Discussionmentioning

confidence: 99%

Twelve-Month Prevalence of Psychiatric Morbidity in Cancer Patients in a Nigerian Oncology Centre

Lasebikan¹,

Fakunle²,

Lasebikan³

et al. 2020

Preprint

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Section: Study Characteristicsmentioning

confidence: 99%

“…The characteristics of the nine included studies were presented in Table 1 (9,10,(15)(16)(17)(18)(19)(20)(21). Among these studies, three were case-control studies (9,19,20), and five were cohort studies (10,(15)(16)(17)(18). The studies involved 4,939 subjects (899 delirium cases and 4,040 non-delirious controls) from five countries.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Risk Factors for Delirium in the Palliative Care Population: A Systematic Review and Meta-Analysis

et al. 2021

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Objective: Delirium is common and highly distressing for the palliative care population. Until now, no study has systematically reviewed the risk factors of delirium in the palliative care population. Therefore, we performed a systematic review and meta-analysis to evaluate delirium risk factors among individuals receiving palliative care.Methods: We systematically searched PubMed, Medline, Embase, and Cochrane database to identify relevant observational studies from database inception to June 2021. The methodological quality of the eligible studies was assessed by the Newcastle Ottawa Scale. We estimated the pooled adjusted odds ratio (aOR) for individual risk factors using the inverse variance method.Results: Nine studies were included in the review (five prospective cohort studies, three retrospective case-control studies and one retrospective cross-section study). In pooled analyses, older age (aOR: 1.02, 95% CI: 1.01–1.04, I2 = 37%), male sex (aOR:1.80, 95% CI: 1.37–2.36, I2 = 7%), hypoxia (aOR: 0.87, 95% CI: 0.77–0.99, I2 = 0%), dehydration (aOR: 3.22, 95%CI: 1.75–5.94, I2 = 18%), cachexia (aOR:3.40, 95% CI: 1.69–6.85, I2 = 0%), opioid use (aOR: 2.49, 95%CI: 1.39–4.44, I2 = 0%), anticholinergic burden (aOR: 1.18, 95% CI: 1.07–1.30, I2 = 9%) and Eastern Cooperative Oncology Group Performance Status (aOR: 2.54, 95% CI: 1.56–4.14, I2 = 21%) were statistically significantly associated with delirium.Conclusion: The risk factors identified in our review can help to highlight the palliative care population at high risk of delirium. Appropriate strategies should be implemented to prevent delirium and improve the quality of palliative care services.

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“…48,49 Most episodes are idiosyncratic and reversible after drug withdrawal. However, ifosfamide encephalopathy can occur hours to days after administration and may be fatal; methylene blue may be helpful.…”

Section: Confusion: Indirect Relation To Cancer Treatmentmentioning

confidence: 99%

The confused oncologic patient: a rational clinical approach

Nolan

DeAngelis

2016

Current Opinion in Neurology

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Purpose of review The purpose of this review is to provide a practical clinical approach to confusion in the patient with cancer. Confusion in the cancer population has a broader differential diagnosis than in the general medical population. The clinician must consider the usual differential diagnoses as well as causes unique to the cancer patient including direct complications from the cancer and indirect complications related to cancer treatment. Recent findings In the recent age of precision medicine, the oncologist now utilizes the genomic profile of both the patient and the tumor to provide advanced biologic therapies including targeted anticancer drugs, antiangiogenic agents, and immunotherapy. Such advances carry with them an emerging pattern of neurotoxicity which, although less well described in the literature, is now an important consideration to the clinical approach to confusion in cancer patients. Summary Confusion is the most common neurologic complication in cancer and is associated with significant morbidity, mortality, and prolonged hospital stays resulting in increased health care costs. Early recognition and treatment of delirium is essential to improve clinical outcomes.

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Chemotherapeutic drugs that penetrate the blood–brain barrier affect the development of hyperactive delirium in cancer patients

Abstract: 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.

Cited by 25 publications

References 30 publications

Twelve-Month Prevalence of Psychiatric Morbidity in Cancer Patients in a Nigerian Oncology Centre

Twelve-Month Prevalence of Psychiatric Morbidity in Cancer Patients in a Nigerian Oncology Centre

Risk Factors for Delirium in the Palliative Care Population: A Systematic Review and Meta-Analysis

The confused oncologic patient: a rational clinical approach

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