Intravenous Chlorpromazine for the Short-Term Treatment of Insomnia in End-Stage Cancer Patients With Difficulty in Oral Administration

J Pain Palliat Care Pharmacother. 2018 Jun-Sep;32(2-3):134-140. doi: 10.1080/15360288.2018.1525468. Epub 2018 Oct 31.

Abstract

The objective of the study was to evaluate effectiveness and safety of intravenous chlorpromazine for the short-term treatment of insomnia in end-stage cancer patients. Insomnia occurs as one of distressing symptoms in 70% of end-stage cancer patients. End-stage cancer patients often have difficulty in oral administration because of disease progress. We retrospectively evaluated 30 end-stage cancer patients with difficulty in oral administration who received intravenous chlorpromazine for the short-term treatment of insomnia. A primary end point was sleep quality based on St. Mary's Hospital Sleep Questionnaire 3 days after the treatment. Improved sleep quality was observed on the day after the treatment and later (P < .001), and the effective rate mean was 0.63 (95% confidential interval: 0.45-0.81) 3 days after the treatment. Increased total sleep time and decreased sleep latency time were observed 3 days after the treatment (P < .001); however, no improvement in depth of sleep was achieved (P = .231). There was no adverse event except for two delirium cases. The study indicated that intravenous chlorpromazine can be applied safely and effectively for the short-term treatment of insomnia in end-stage cancer patients with difficulty in oral administration.

Keywords: Difficulty in oral administration; end-stage cancer; insomnia; intravenous chlorpromazine; safety; sleep quality.

MeSH terms

  • Administration, Intravenous
  • Administration, Oral
  • Adult
  • Aged
  • Aged, 80 and over
  • Antipsychotic Agents / administration & dosage*
  • Antipsychotic Agents / adverse effects
  • Chlorpromazine / administration & dosage*
  • Chlorpromazine / adverse effects
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Neoplasms / complications*
  • Neoplasms / pathology
  • Retrospective Studies
  • Sleep / drug effects
  • Sleep Initiation and Maintenance Disorders / drug therapy*
  • Sleep Initiation and Maintenance Disorders / etiology
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome
  • Young Adult

Substances

  • Antipsychotic Agents
  • Chlorpromazine