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Pharmacological Treatment of Psychotic Disorders

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Psychopharmacology in Oncology and Palliative Care

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Abstract

Treatment of psychotic disorders in cancer patients represents a challenge for clinicians. Psychotic symptoms (e.g., delusions, perceptual disorders), unusual behavior or inappropriate affect, and low adherence may be a problem for healthcare teams in oncology and palliative care. Pharmacotherapy is the key of management of psychotic disorders, along with psychosocial therapies. Antipsychotic agents (APs) (first-generation or typical or conventional APs; atypical APs), benzodiazepines, or possibly certain anticonvulsants are used to manage psychotic disorders in cancer and palliative care settings. Attention to side effects of APs, including extra-pyramidal symptoms (e.g., acute dystonia, akathisia, parkinsonism-like symptoms, and tardive dyskinesia), possible anti-muscarinic symptoms (e.g., xerostomia, tachycardia, peristalsis impairment, urinary retention), neuroleptic malignant syndrome, and others, is necessary. Also possible cardiologic side effects (e.g., increase QTc length) should be monitored. Drug–drug interaction, given the possible overlapping of metabolic pathways (cytochrome P-450 enzyme systems) between APs and anticancer or palliative care medications, needs also to be carefully examined when prescribing drugs to psychotic patients with cancer.

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Author information

Authors and Affiliations

  1. Mental Health Clinic, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, Gyeonggi-do, Republic of Korea

    Jong-Heun Kim

  2. Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan, ROC

    Chun-Kai Fang

  3. Hospice and Palliative Care Center (HPCC) & Suicide Prevention Center (SPC), Mackay Memorial Hospital, Taipei, Taiwan, ROC

    Chun-Kai Fang

Authors
  1. Jong-Heun Kim
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  2. Chun-Kai Fang
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Corresponding author

Correspondence to Jong-Heun Kim .

Editor information

Editors and Affiliations

  1. Biomedical & Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy

    Luigi Grassi

  2. Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA

    Michelle Riba

Suggested Further Readings

Suggested Further Readings

  • Foti ME. Palliative care for patients with serious mental illness. In: Chochinov HM, Breitbart W, editors. Handbook of psychiatry in palliative medicine. New York: Oxford; 2009.

  • Ganzini L, Socherman R. Cancer care for patients with schizophrenia. In: Holland JC et al., editors. Psycho-oncology. New York: Oxford; 2010.

  • Leigh H. Psychosis. In: Leigh H, Streltzer J, editors. Handbook of consultation-liaison psychiatry. New York: Springer; 2007.

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© 2014 Springer-Verlag Berlin Heidelberg

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Kim, JH., Fang, CK. (2014). Pharmacological Treatment of Psychotic Disorders. In: Grassi, L., Riba, M. (eds) Psychopharmacology in Oncology and Palliative Care. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-40134-3_13

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  • DOI: https://doi.org/10.1007/978-3-642-40134-3_13

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-40133-6

  • Online ISBN: 978-3-642-40134-3

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