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Drug-induced akathisia as a cause of distress in spouse caregivers of cancer patients

Published online by Cambridge University Press:  04 May 2011

Mei Wada*
Affiliation:
Department of Psycho-Oncology, Saitama Medical University International Medical Center, Saitama, Japan Department of Medical Psychology, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan
Hiroshi Ito
Affiliation:
Department of Palliative Care, Saitama Medical University International Medical Center, Saitama, Japan
Makoto Wada
Affiliation:
Department of Psycho-Oncology, Saitama Cancer Center, Saitama, Japan
Tomomi Wada
Affiliation:
Department of Psycho-Oncology, Saitama Cancer Center, Saitama, Japan
Yukio Tada
Affiliation:
Department of Psycho-Oncology, Saitama Medical University International Medical Center, Saitama, Japan
Mayumi Ishida
Affiliation:
Department of Psycho-Oncology, Saitama Medical University International Medical Center, Saitama, Japan Graduate School of Human Sciences, Waseda University, Saitama, Japan Research Fellow of the Japan Society for the Promotion of Science
Keiko Mizuno
Affiliation:
Department of Palliative Care, Saitama Medical University International Medical Center, Saitama, Japan
Atsuko Shioi
Affiliation:
Department of Nursing, Saitama Medical University International Medical Center, Saitama, Japan
Masaru Narabayashi
Affiliation:
Department of Palliative Care, Saitama Medical University International Medical Center, Saitama, Japan
Yumi Iwamitsu
Affiliation:
Department of Medical Psychology, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan
Hideki Onishi
Affiliation:
Department of Psycho-Oncology, Saitama Medical University International Medical Center, Saitama, Japan
*
Address correspondence and reprint requests to: Mei Wada, Department of Psycho-Oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-City, Saitama, 350-1298, Japan. E-mail: [email protected]

Abstract

Objective:

Family caregivers of cancer patients suffer from physical, psychological, and social distress and therefore are often referred to as second order patients. Akathisia is a common side effect of antipsychotics and antidepressants that causes great discomfort and even agitation and is often described by patients administered these drugs as the most distressing side effect of their treatment. Several studies of akathisia as a cause of distress in cancer patients have been reported. However, akathisia has not been reported as a cause of distress in family caregivers of cancer patients.

Method/Case report:

A 74-year-old spouse caregiver who was under treatment for major depressive disorder was not able to visit the hospital where her husband, a terminally ill cancer patient, was being treated. Initially, the spouse caregiver thought that she could not visit the hospital because of the symptoms of her depression and her grief about losing her husband. However, careful clinical examination revealed that she was suffering from akathisia in addition to her grief.

Results:

Discontinuation of her sulpiride treatment resulted in the disappearance of her akathisia symptoms, and therefore she became able to visit the hospital and care for her terminally ill husband.

Significance of results:

Drug induced akathisia is a cause of distress in spouse caregivers taking certain drugs. It is important for clinicians to realize that family caregivers might suffer from not only socioeconomic, physical, and psychological problems but also side effects of medication.

Type
Case Report
Copyright
Copyright © Cambridge University Press 2011

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References

REFERENCES

American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders Fourth Edition, Text Revision. Washington, DC: American Psychiatric Press.Google Scholar
Braun, M., Mikulincer, M., Rydall, A., et al. (2007). Hidden morbidity in cancer: Spouse caregivers. Journal of Clinical Oncology, 25, 48294834.CrossRefGoogle ScholarPubMed
Carter, P.A. (2002). Caregivers' descriptions of sleep changes and depressive symptoms. Oncology Nursing Forum, 29, 12771283.CrossRefGoogle ScholarPubMed
Cem Atbasoglu, E., Schultz, S.K. & Andreasen, N.C. (2001). The relationship of akathisia with suicidality and depersonalization among patients with schizophrenia. Journal of Neuropsychiatry and Clinical Neurosciences, 13, 336341.CrossRefGoogle ScholarPubMed
Covinsky, K.E., Goldman, L., Cook, E.F., et al. (1994). The impact of serious illness on patients' families. SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment. Journal of the American Medical Association, 272, 18391844.CrossRefGoogle ScholarPubMed
Fleishman, S.B., Lavin, M.R., Sattler, M., et al. (1994). Antiemetic-induced akathisia in cancer patients receiving chemotherapy. American Journal of Psychiatry, 151, 763765.Google ScholarPubMed
Francis, J., Martin, D. & Kapoor, W.N. (1990). A prospective study of delirium in hospitalized elderly. Journal of the American Medical Association, 263, 10971101.Google Scholar
Hebert, R.S., Schulz, R., Copeland, V.C., et al. (2009). Preparing family caregivers for death and bereavement. Insights from caregivers of terminally ill patients. Journal of Pain and Symptom Management, 37, 312.CrossRefGoogle ScholarPubMed
Heyland, D.K., Dodek, P., Rocker, G., et al. (2006). What matters most in end-of-life care: Perceptions of seriously ill patients and their family members. Canadian Medical Association Journal, 174, 627633.Google Scholar
Hirose, S. (2003). The causes of underdiagnosing akathisia. Schizophrenia Bulletin, 29, 547558.Google Scholar
Holmes, T.H. & Rahe, R.H. (1967). The Social Readjustment Rating Scale. Journal of Psychosomatic Research, 11, 213218.Google Scholar
Hsin-Tung, E. & Simpson, G.M. (2000). Medication-induced movement disorders. In Comprehensive Textbook of Psychiatry (7th ed.). Sadock, B., & Sadock, V.A. (eds.), pp. 22672268. Philadelphia: Lippincott Williams & Wilkins.Google Scholar
Janno, S., Holi, M., Tuisku, K., et al. (2004). Prevalence of neuroleptic-induced movement disorders in chronic schizophrenia inpatients. American Journal of Psychiatry, 161, 160163.Google Scholar
Jimenez-Jimenez, F.J., Garcia-Ruiz, P.J. & Molina, J.A. (1997). Drug-induced movement disorders. Drug Safety, 16, 180204.CrossRefGoogle ScholarPubMed
Kawanishi, C., Onishi, H., Kato, D., et al. (2007). Unexpectedly high prevalence of akathisia in cancer patients. Palliative & Supportive Care, 5, 351354.Google Scholar
Khawam, E.A., Laurencic, G. & Malone, D.A. Jr. (2006). Side effects of antidepressants: An overview. Cleveland Clinic Journal of Medicine, 73, 351353, 356–361.Google Scholar
Kiecolt-Glaser, J.K., Glaser, R., Gravenstein, S., et al. (1996). Chronic stress alters the immune response to influenza virus vaccine in older adults. Proceedings of the National Academy of Sciences of the United States of America, 93, 30433047.Google Scholar
Lederberg, M.S. (1998). The Family of the Cancer Patient. New York: Oxford University Press.Google Scholar
Northouse, L.L., Mood, D., Templin, T., et al. (2000). Couples' patterns of adjustment to colon cancer. Social Science & Medicine, 50, 271284.CrossRefGoogle ScholarPubMed
Onishi, H., Onose, M., Okuno, S., et al. (2005). Spouse caregivers of terminally-ill cancer patients as cancer patients: A pilot study in a palliative care unit. Palliative & Supportive Care, 3, 8386.CrossRefGoogle Scholar
Onishi, H., Yamamoto, W., Wada, M., et al. (2007). Detection and treatment of akathisia in advanced cancer patients during adjuvant analgesic therapy with tricyclic antidepressants: case reports and review of the literature. Palliative & Supportive Care, 5, 411414.CrossRefGoogle ScholarPubMed
Prigerson, H.G., Shear, M.K., Frank, E., et al. (1997). Traumatic grief: A case of loss-induced trauma. American J Psychiatry, 154, 10031009.Google ScholarPubMed
Rodgers, C. (1992). Extrapyramidal side effects of antiemetics presenting as psychiatric illness. General Hospital Psychiatry, 14, 192195.Google Scholar
Shaw, W.S., Patterson, T.L., Semple, S.J., et al. (1997). Longitudinal analysis of multiple indicators of health decline among spousal caregivers. Annals of Behavioral Medicine, 19, 101109.CrossRefGoogle ScholarPubMed
Shear, M.K., Frances, A. & Weiden, P. (1983). Suicide associated with akathisia and depot fluphenazine treatment. Journal of Clinical Psychopharmacology, 3, 235236.Google Scholar
Siris, S.G. (1985). Three cases of akathisia and “acting out.” Journal of Clinical Psychiatry, 46, 395397.Google Scholar