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

Published online by Cambridge University Press:  26 June 2014

Hiromichi Matsuoka ,
Kazuhiro Yoshiuchi ,
Atsuko Koyama ,
Masatomo Otsuka  and
Kazuhiko Nakagawa
Hiromichi Matsuoka*
Affiliation:
Department of Medical Oncology, Division of Psychosomatic Medicine, Kinki University Faculty of Medicine, Osaka, Japan
Kazuhiro Yoshiuchi
Affiliation:
Department of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
Atsuko Koyama
Affiliation:
Department of Medical Oncology, Division of Psychosomatic Medicine, Kinki University Faculty of Medicine, Osaka, Japan
Masatomo Otsuka
Affiliation:
Department of Palliative Care Medicine, Sakai Hospital, Kinki University Faculty of Medicine, Osaka, Japan
Kazuhiko Nakagawa
Affiliation:
Department of Medical Oncology, Kinki University Faculty of Medicine, Osaka, Japan
*
Address correspondence and reprint requests to: Hiromichi Matsuoka, Department of Medical Oncology, Division of Psychosomatic Medicine, Kinki University Faculty of Medicine, 377-2, Ohno-Higashi, Osaka Sayama City, Osaka, 589-8511, Japan. E-mail: [email protected]
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Abstract

Objective:

Delirium is a frequently encountered psychiatric disease in terminal cancer patients. However, the mechanism of delirium is unclear. The aim of our study was to investigate the relationship between administration of chemotherapy drugs that penetrate the blood–brain barrier (BBB) and the development of delirium in cancer patients.

Method:

We retrospectively analyzed 166 cancer patients (97 males, 69 females) continuously who died between September of 2007 and January of 2010 using a review of medical charts. Multiple logistic regression analysis was employed to investigate the effects of antineoplastic drugs penetrating the BBB on development of delirium in cancer patients with control for other risk factors.

Results:

In multivariate analysis, antineoplastic drugs that penetrated the BBB were significantly associated with development of delirium (OR = 18.92, CI95 = 1.08–333.04, p < 0.001).

Significance of results:

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.

Keywords

Cancer patientsChemotherapeutic drugsDeliriumBlood–brain barrierP glycoprotein
Type
Original Articles
Information
Palliative & Supportive Care , Volume 13 , Issue 4 , August 2015 , pp. 859 - 864
Copyright
Copyright © Cambridge University Press 2014 

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