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Psychostimulants and delirium in patients receiving palliative care

Published online by Cambridge University Press:  04 April 2005

J.C. KEEN
Affiliation:
Highland Hospice, Inverness, United Kingdom
D. BROWN
Affiliation:
St. Columba's Hospice, Edinburgh, United Kingdom

Abstract

The use of psychostimulants to relieve opioid-induced drowsiness and symptoms of depression in medically ill patients has become increasingly established in North America. The role of psychostimulants in the care of patients receiving palliative care is beginning to be debated in the United Kingdom both in the hospice and hospital setting. Delirium has been well defined and reported as a significant problem in populations of patients receiving palliative care. Two case histories are presented to illustrate the potential benefit of psychostimulants in hypoactive delirium.

Type
CASE REPORT
Copyright
© 2004 Cambridge University Press

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References

REFERENCES

Breitbart, W., Bruera, E., Chochinov, H., et al. (1995). Neuropsychiatric syndromes and psychiatric symptoms in patients with advanced cancer. Journal of Pain and Symptom Management, 10, 131141.Google Scholar
Bruera, E., Brenneis, C., Paterson, A.H., et al. (1989). Use of methylphenidate as an adjuvant to narcotic analgesics in patients with advanced cancer. Journal of Pain and Symptom Management, 4, 36.Google Scholar
Bruera, E., Fainsinger, R., MacEachern, T., et al. (1992). The use of methylphenidate in patients with incident cancer pain receiving regular opiates. A preliminary report. Pain, 50, 7577.Google Scholar
Emptage, R. & Semla, T. (1996). Depression in the medically ill: A focus on methylphenidate. Annals of Pharmacotherapy, 30, 151157.Google Scholar
Gagnon, P., Allard, P., Masse, B., et al. (2000). Delirium in terminal cancer: A prospective study using daily screening, early diagnosis, and continuous monitoring. Journal of Pain and Symptom Management, 19, 412426.Google Scholar
Inouye, S.K., van Dyke, C.H., Alessi, C.A., et al. (1990). Clarifying confusion: The confusion assessment method. A new method for detection of delirium. Annals of Internal Medicine, 113, 941948.Google Scholar
Lawlor, P.G., Gagnon, B., Mancini, I.L., et al. (2000). Occurrence, causes, and outcome of delirium in patients with advanced cancer: A prospective study. Archives of Internal Medicine, 160, 786794.Google Scholar
Lipowski, Z.J. (1980). Delirium: Acute Brain Failure in Man. Springfield, IL: Charles C. Thomas Publishers.
Macleod, A. (1998). Methylphenidate in terminal depression. Journal of Pain and Symptom Management, 16, 193198.Google Scholar
Masand, P.S. & Tesar, G. (1996). Use of stimulants in the medically ill. Psychiatric Clinics of North America, 19, 515547.Google Scholar
Morita, T., Otani, H., Tsunoda, J., et al. (2000). Successful palliation of hypoactive delirium due to multi-organ failure by oral methylphenidate. Supportive Care in Cancer, 8, 134137.Google Scholar
O'Keefe, S.T. & Lavan, J.N. (1999). Clinical significance of delirium subtypes in older people. Age and Aging, 28, 115119.Google Scholar
Olin, J. & Masand, P. (1996). Psychostimulants for depression in hospitalised cancer patients. Psychosomatics, 37, 5762.Google Scholar
Passik, S.D. & Cooper, M. (1999). Complicated delirium in a cancer patient successfully treated with olanzapine. Journal of Pain and Symptom Management, 17, 219223.Google Scholar
Pereira, J. & Bruera, E. (2001). Depression with psychomotor retardation: Diagnostic challenges and the use of psychostimulants. Journal of Palliative Medicine, 4, 1521.Google Scholar
Stiefel, F. & Bruera, E. (1991). Psychostimulants for hypoactive-hypoalert delirium. Journal of Palliative Care, 7, 2526.Google Scholar
Wallace, A.E., Kofoed, L.L., & West, A.N. (1995). Double-blind, placebo-controlled trial of methylphenidate in older, depressed, medically ill patients. American Journal of Psychiatry, 152, 929931.Google Scholar