Psychopharmacology in Oncology and Palliative Care: A Practical Manual PDF
Preview Psychopharmacology in Oncology and Palliative Care: A Practical Manual
Psychopharmacology in Oncology and Palliative Care A Practical Manual Luigi Grassi Michelle Riba Editors WORLD PSYCHIATRIC ASSOCIATINO www.wpanet.org Psychopharmacology in Oncology and Palliative Care ThiSisaFMBlankPage Luigi Grassi (cid:129) Michelle Riba Editors Psychopharmacology in Oncology and Palliative Care A Practical Manual Editors LuigiGrassi MichelleRiba Instituteof Psychiatry DepartmentofPsychiatry DepartmentofBiomedical&Specialty UniversityofMichigan SurgicalSciences AnnArbor,Michigan UniversityofFerrara USA Ferrara,Italy ISBN978-3-642-40133-6 ISBN978-3-642-40134-3(eBook) DOI10.1007/978-3-642-40134-3 SpringerHeidelbergNewYorkDordrechtLondon LibraryofCongressControlNumber:2014943454 #Springer-VerlagBerlinHeidelberg2014 Thisworkissubjecttocopyright.AllrightsarereservedbythePublisher,whetherthewholeorpart of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation,broadcasting,reproductiononmicrofilmsorinanyotherphysicalway,andtransmissionor informationstorageandretrieval,electronicadaptation,computersoftware,orbysimilarordissimilar methodologynowknownorhereafterdeveloped.Exemptedfromthislegalreservationarebriefexcerpts inconnectionwithreviewsorscholarlyanalysisormaterialsuppliedspecificallyforthepurposeofbeing enteredandexecutedonacomputersystem,forexclusiveusebythepurchaserofthework.Duplication ofthispublicationorpartsthereofispermittedonlyundertheprovisionsoftheCopyrightLawofthe Publisher’s location, in its current version, and permission for use must always be obtained from Springer.PermissionsforusemaybeobtainedthroughRightsLinkattheCopyrightClearanceCenter. ViolationsareliabletoprosecutionundertherespectiveCopyrightLaw. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publicationdoesnotimply,evenintheabsenceofaspecificstatement,thatsuchnamesareexempt fromtherelevantprotectivelawsandregulationsandthereforefreeforgeneraluse. While the advice and information in this book are believed to be true and accurate at the date of publication,neithertheauthorsnortheeditorsnorthepublishercanacceptanylegalresponsibilityfor anyerrorsoromissionsthatmaybemade.Thepublishermakesnowarranty,expressorimplied,with respecttothematerialcontainedherein. Printedonacid-freepaper SpringerispartofSpringerScience+BusinessMedia(www.springer.com) Foreword TheeditorsofPsychopharmacologyinOncologyandPalliativeCare:APractical Manual, published by the World Psychiatric Association, have graciously invited me to write the foreword. The attention to psychopharmacology comes after the firstbookintheseriescoveringthegeneralprinciplesonwhichpsycho-oncologyis based. It is a tribute to the field that sufficient information exists today with an evidencebaseandthatatextbookcanbepublishedfocusingonthepharmacologic interventionsalone.Itisgoingtoserveasabenchmarkinthefieldinternationally. ThebookrepresentsthecontinuingcollaborationbetweentheWorldPsychiatric Association and the International Psycho-Oncology Society tomakeavailable the most recent clinical and research approaches to psychiatric care of patients with cancer. Drs. Grassi and Riba have called on global experts in specific areas to provide updates relevant to the psychiatric, psychosocial, and ethical care of children, elders, and those receiving palliative care for cancer. Such topics as delirium, depression, anxiety, sleep, substance abuse, pain, fatigue, and sexual disordersareoftenneglectedbytreatingphysiciansandtheirteamsduetolackof knowledgeabouttherangeofevidence-basedinterventionsavailable. This book, written largely by psychiatrists and psychologists, outlines the information needed to improve care, outlined in succinct and readable language. Patientsaroundtheworldwillexperienceabetterqualityoflifeastheygothrough the cancer journey because of the information made available to their physicians throughthechaptersinthisbook. NewYork,NY JimmieHolland February4,2014 WayneE.ChapmanChairinPsychiatricOncology, MemorialSloanKetteringCancerCenter ProfessorofPsychiatry,WeillCornellMedicalCollege v ThiSisaFMBlankPage Preface Psycho-oncology has grown exponentially over the last years, with a mandatory indication for multidisciplinary intervention and inclusion of psycho-oncology programswithinmanynationalcancerplanacts.Theneedforpsychosocialtraining ofallhealthcareprofessionalsworkinginoncologyisnowconsideredessentialfor goodqualityofcancercare. Psychopharmacologyhas acentral specific rolebothbecause oftheefficacyof psychotropic drugs in the treatment of psychiatric disorders secondary to cancer andbecauseofthenewdataderivedbypsychopharmacologicalresearchinpsychi- atrythat,whenappliedinoncologyandpalliativecare,maybeofextremehelpin relieving cancer patients from their suffering. A manual or practical text on psychopharmacology in oncology has been lacking, and for this reason, the idea of this book originated with the intention to fill this gap, by giving clinicians practical indicationsandsuggestionsrelativetotheefficacyandsafetyofpsycho- tropic drugs in the treatment of psychiatric disorders in cancer patients across the trajectoryofdisease.Oneofthemainaimsofthebookisinfacttopresentthemain issuesinvolvedinpsychopharmacologicalmanagementofpsychiatricdisordersin cancerandpalliativecare,accordingtothedifferentpossiblepsychiatricdiagnoses, with special attention to have psychopharmacological intervention within a broad frameworkofanintegrativepsychosocial,patient-centeredapproach.Asecondaim is to illustrate the significant and challenging problems clinicians may encounter (e.g., drugs, pharmacological characteristics, side effects, drug–drug interaction, doses,androuteofadministration)includingtheemergingthemeofadjuvantuseof psychotropicdrugsforthetreatmentofsymptoms/syndromesnotmainlyrelatedto psychiatricdisorders(e.g.,pain,hot-flashes,fatigue).Athirdaimistoexaminethe needs of special populations, including children and adolescents, as well as the elderly,affectedbycancer,whenpsychopharmacologytreatmentisindicated. Thebookconsistsofthreeparts.InPartI,thegeneralaspectsinpsychopharma- cological treatment, with specific reference to oncology and palliative care, are examined.Chapter1,byGrassiandRiba,servestodelineatethechangesintheuse ofpsychotropicdrugsasapillarofinterventionforpsychiatricdisordersincancer careandtheneedforreconceptualizingpsychopharmoncologyasanintegrationof psychosocial and psychopharmacological treatments in clinical practice. In Chap.2,RothandAliciprovideanoverview ofthegeneralprinciplesofpharma- cokinetics and pharmacodynamics with a focus on psychotropic medications vii viii Preface commonly used for patients with cancer and in palliative care settings. The most significant diagnostic issues in terms of need for a comprehensive psychiatric interview and mental status examination when conducted in oncology and pallia- tivecaresettingsandaproperuseofpsychiatrictaxonomicsystemsarediscussed byGrassi,Nanni,andRibainChap.3.MitchellandBultzdiscuss,inChap.4,the need for a proper psychosocial assessment of cancer patients when planning for psychopharmacological intervention. Screening for anxiety and depression, dis- tress,cognitivedecline,adaptationtoillness,aswellasunmetneedsandwell-being are comprehensively described by the authors. Chapter 5, by Grassi, Caruso and Baile,dealswiththeimportanceofcommunicationandinterpersonalrelationships inthediagnosticphaseandintheshareddecisionmakinginplanningapsychophar- macologicalintervention,withparticularreferencetotheproblemofadherence.In Chap. 6, Kogon and Spiegel underline the importance of a careful integration of psychosocial and psychopharmacological treatment in cancer care. The authors discuss the need for attention to the symbolic communication when clinicians propose psychopharmacological treatment and the benefit of combining and integrating psychotropic medication and psychosocial interventions. Tang and Fielding in Chap. 7 examine the important theme of complementary and noncon- ventional treatments. More specifically, the role of traditional Chinese medicine, including herbal formulations, acupuncture, and activity-based interventions (QigongandTaiChiChuane),andyogaisdescribedwithreferencetointegration with psychopharmacology, and as a practice that more and more frequently is providedincancersettings. PartIIofthisbookisdedicatedtotheuseofpsychotropicdrugsforthetreatment ofthespecificpsychiatricdisordersinclinicaloncologyandpalliativecaresettings. In Chap. 8, Shimizu, Yosiuchi, and Onishi offer an overview of the treatment of anxietydisordersandtrauma-andstressor-relateddisorders,accordingtothemost recent changes provided by the DSM-5, and present the role of medications with anti-anxiety properties and their adverse effects and drug interactions. The extremely debated area of depression and depressive disorders is the focus of Chap. 9 by Fitzgerald, Li, Grassi, and Rodin, who comprehensively discuss the needforappropriatediagnosisofdepression,includingacarefulexaminationofthe patient’s medical condition, for a correct prescription of antidepressant medications, which takes into account both the profile of action and the potential adverse effects and drug–drug interactions. Chaturvedi, Torta, and Ieraci summa- rizeinChap.10thecomplexproblemofpharmacologicaltreatmentofsomatoform disorders and other somatic symptom conditions (e.g., pain, fatigue, hot-flashes, pruritus, anorexia and weight loss, and nausea and vomiting). The importance of sensitiveexplorationofsomaticsymptoms,examinationofpossiblebiologicaland neurotransmitter mechanisms, and appropriate intervention are highlighted by the authors. In Chap. 11, the significant, though underestimated, area of bipolar disorders,asaparticularchallengefortheoncologyteam,isreviewedbyEllingrod, Hertz, and McInnis, who discuss psychopharmacological clinical strategies for thesedisordersand,ingeneral,unstablemoodinpatientswithcancer,emphasizing theneedforregularmonitoringofclinicalmoodsymptoms,medicationlevels,and Preface ix physical health. In Chap. 12, the correct approach to delirium, as one of the most commonneuropsychiatriccomplications,associatedwithsignificantmorbidityand mortality,isprovidedbyBreitbartandAlici,whopresentadetailedoverviewofthe pharmacological management options for the disorder in cancer patients and in palliative care settings. The role of multidisciplinary team intervention for psy- chotic disorders is presented in Chap. 13 by Kim and Fang who discuss how to integrate proper psychopharmacotherapy (e.g., choice of drugs, dosages, side effects, drug–drug interactions) and communication strategies when treating both patients with severe mental illness who have developed cancer and those who developedpsychoticdisordersasaconsequenceofcancer.InChap.14,Monteiro, Ribeiro,andXavierreviewthevastandimportantarearelativetothetreatmentof sleep disorders, as a significant, yet underestimated problem to be addressed in cancerandpalliativecaresettings.Screeningofsleepcomplaints,classificationof the several expression of sleep disorders, evaluation of the possible etiologic factors, and correct treatment are comprehensively discussed. The significant problem of substance and alcohol abuse in cancer is reviewed in Chap. 15 by Passik, Miller, Ruhele, and Kirsh who discuss the impact of these behaviors on potentially life-saving and life-extending cancer treatments and the need for the application of addiction medicine techniques and interventions in cancer care. In Chap.16,BenedictandNelsonfocusattentiononcancer-relatedchangesinsexual function by reviewing the possible interventions for both male and female cancer patients,includingtheuseofmedical,educational,andpsychologicalstrategies,to facilitate sexual recovery and promote satisfying sexual experiences for patients andtheirpartners. Inthethirdpartofthebook,somespecialissuesrelativetopsychopharmacology inoncologyandpalliativecarearetakenintoconsideration.InChap.17,Lynnand Valentine alert clinicians to the possible emergencies or dangers arising from pharmacologicmanagement,includingserotoninsyndrome,neurolepticmalignant syndrome,andoverdoseofpsychotropicdrugscommonlyutilizedinoncologyand palliativecare.ForgeyandBursch,inChap.18,offerathoroughdescriptionofthe veryimportantareaofchildhoodcancer,withspecificreferencetopsychopharma- cological treatment recommendations for children with cancer, within a larger framework of behavioral and family-based interventions management. The age-related physiological changes that may affect the response to psychotropic medication and their clinical implications for the use of psychopharmacologic treatments in elderly patients with cancer are the aims of Chap. 19 by Iaboni, Fitzgerald, and Rodin. In the following Chap. 20, Ferrari and Caraceni offer an in-depth insight regarding end-of-life care, with specific reference to palliative sedation therapy (PST). Evidence-based use of some psychotropic drugs is describedbytheauthorstohelpcancerandpalliativecarephysicianswhendealing with refractory symptoms (e.g., delirium, dyspnea, pain, nausea and vomiting) at theendoflife.InChap.21,AliciandDunnpointoutthetopic ofpsychopharma- cology research in oncology and palliative care, considering the problems and urgent needs to be addressed (e.g., limited number of studies, methodological limitations, the challenges in establishing psychiatric diagnoses, the validity of
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