A pilot exploration of the antiemetic activity of olanzapine for the relief of nausea in patients with advanced cancer and pain.
Open accessAbstract
This open-label pilot study explored the antiemetic activity of olanzapine, an atypical antipsychotic, in patients with advanced cancer requiring opioid analgesics for pain. Fifteen patients received 2 days of a washout and placebo "run-in" followed by two day periods on each of three doses of olanzapine (2.5 mgs, 5 mgs, and 10 mgs). Patients completed a daily food journal as well as the Mini Mental State Exam, Simpson Angus Scale, Barnes Akathisia Scale, and the Functional Assessment of Cancer Therapy-General across four time periods, with special attention being placed on the nausea item. Eleven women and 4 men with varied primary cancer sites participated. The average age of the sample was 58 years (SD = 16.8). All three dose levels were associated with significant reductions in nausea compared to baseline. Diary entries recorded by the subjects suggested substantial benefits to overall well being and the 5mg condition was associated with statistically significant improvement in overall quality of life over baseline (F = 12.0, p < 0.005). No extrapyramidal symptoms were noted and mental status exams were not changed over the course of the eight days. These results suggest an antiemetic effect for olanzapine and indicate the need for a controlled trial.
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The magnitude of benefit of olanzapine for nausea/vomiting observed in this trial is in line with what has been reported in 3 other pilot reports.
“The magnitude of benefit observed in this trial, regarding nausea/vomiting, is in line with what has been reported in 3 other pilot reports.8,12,13”
From Olanzapine for the Treatment of Advanced Cancer–Related Chronic Nausea and/or Vomiting: A Randomized Pilot Trial (2020) · cites this paper as [8]
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- Authors
- Passik, S. D., Lundberg, J., Kirsh, K. L., Theobald, D., Donaghy, K., Holtsclaw, E., Cooper, M., & Dugan, W.
- Affiliations
- Markey Cancer Center (US)
- Corresponding author
- Passik, Steven D.
- Venue
- Journal of Pain and Symptom Management
- Publisher
- Elsevier BV
- Published
- 2002-06
- Volume
- 23
- Issue
- 6
- Pages
- 526-532
- ISSN
- 0885-3924 (ISSN-L)
- OpenAlex
- W2027393266
- Semantic Scholar
- f9eaa050229fb9860cecff4f581d7d4274d6af00
- Cited by
- 154
- References
- 23
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 5 · 2023: 3 · 2022: 2 · 2021: 9 · 2020: 6 · 2019: 6 · 2018: 6 · 2017: 6 · 2016: 10 · 2015: 17 · 2014: 8 · 2013: 9 · 2012: 10
- FWCI
- 3.81
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Pain and Symptom Management (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Eli Lilly and Company
- Topics
- Health Sciences › Medicine › Surgery › Nausea and vomiting management
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Keywords
- olanzapine, antiemetic activity, nausea, advanced cancer, cancer pain, opioid analgesics, atypical antipsychotics, quality of life, extrapyramidal symptoms, akathisia, functional status
- MeSH terms
- Olanzapine, Adolescent, Adult, Aged, Aged, 80 and over, Antiemetics, Benzodiazepines, Dyskinesia, Drug-Induced, Female, Humans, Male, Middle Aged, Nausea, Neoplasms, Pain, Palliative Care, Pilot Projects, Pirenzepine
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