Off-label Medication Use of Asenapine Sublingual Tablets for Agitated Delirium in Cancer Patients at the End of Life

Delirium occurs in 30-40% of patients with terminal cancer, and 90% of patients are delirious immediately before death. Symptoms such as agitation and hallucination are often refractory to the standard pharmacological therapy. Also, the medication options for delirium in terminally ill patients are...

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Veröffentlicht in:Palliative Care Research 2021, Vol.16(3), pp.261-265
Hauptverfasser: Nakano, Hiroki, Akashi, Naoko, Wada, Tomomi, Ide, Kyoko, Inoue, Atsuyuki, Miyabe, Takashi, Yamauchi, Kazutaka
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container_end_page 265
container_issue 3
container_start_page 261
container_title Palliative Care Research
container_volume 16
creator Nakano, Hiroki
Akashi, Naoko
Wada, Tomomi
Ide, Kyoko
Inoue, Atsuyuki
Miyabe, Takashi
Yamauchi, Kazutaka
description Delirium occurs in 30-40% of patients with terminal cancer, and 90% of patients are delirious immediately before death. Symptoms such as agitation and hallucination are often refractory to the standard pharmacological therapy. Also, the medication options for delirium in terminally ill patients are often limited due to a difficulty in swallowing or a lack of intravenous access. We herein report a case series of six patients with terminal cancer whose derilium symptoms were treated by asenapine sublingual tablets during the intervention period by the palliative care team. Asenapine was selected when other antipsychotics were ineffective or unavailable for agitation caused by delirium. All patients suffered dyspnea or choking sensations due to dysphagia or respiratory dysfunction. Sedative effect was observed among all patients without apparent adverse events. Sublingual asenapine could be an option for the management of restlessness due to terminal delirium when both oral and intravenous drug administration routes are not available.
doi_str_mv 10.2512/jspm.16.261
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subjects asenapine
delirium
terminal cancer patients
title Off-label Medication Use of Asenapine Sublingual Tablets for Agitated Delirium in Cancer Patients at the End of Life
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