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A case of respiratory akathisia in a cancer patient: A case report

Published online by Cambridge University Press:  19 February 2008

Yu Sunakawa*
Affiliation:
Department of Clinical-Oncology, Comprehensive Cancer Center, Saitama Medical University International Medical Center, Saitama, Japan
Makoto Wada
Affiliation:
Department of Psycho-Oncology, Comprehensive Cancer Center, Saitama Medical University International Medical Center, Saitama, Japan
Tomomi Nishida
Affiliation:
Department of Psycho-Oncology, Comprehensive Cancer Center, Saitama Medical University International Medical Center, Saitama, Japan
MEI Wada
Affiliation:
Department of Psycho-Oncology, Comprehensive Cancer Center, Saitama Medical University International Medical Center, Saitama, Japan
Kazuhiro Araki
Affiliation:
Department of Clinical-Oncology, Comprehensive Cancer Center, Saitama Medical University International Medical Center, Saitama, Japan
Hisashi Endo
Affiliation:
Department of Clinical-Oncology, Comprehensive Cancer Center, Saitama Medical University International Medical Center, Saitama, Japan
Fumio Nagashima
Affiliation:
Department of Clinical-Oncology, Comprehensive Cancer Center, Saitama Medical University International Medical Center, Saitama, Japan
Wataru Ichikawa
Affiliation:
Department of Clinical-Oncology, Comprehensive Cancer Center, Saitama Medical University International Medical Center, Saitama, Japan
Toshimichi Miya
Affiliation:
Department of Clinical-Oncology, Comprehensive Cancer Center, Saitama Medical University International Medical Center, Saitama, Japan
Hideki Onishi
Affiliation:
Department of Psycho-Oncology, Comprehensive Cancer Center, Saitama Medical University International Medical Center, Saitama, Japan
Masaru Narabayashi
Affiliation:
Department of Clinical-Oncology, Comprehensive Cancer Center, Saitama Medical University International Medical Center, Saitama, Japan Department of Palliative Medicine, Comprehensive Cancer Center, Saitama Medical University International Medical Center, Saitama, Japan
Yasutsuna Sasaki
Affiliation:
Department of Clinical-Oncology, Comprehensive Cancer Center, Saitama Medical University International Medical Center, Saitama, Japan
*
Address correspondence and reprint requests to: Yu Sunakawa, Department of Clinical-Oncology, Conprehensive Cancer Center, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan. E-mail: yu_s@saitama-med.ac.jp

Abstract

Objective:

It has been reported that akathisia is a neurological side effect induced by antiemetic drugs and/or antipsychotics. Akathisia can occur in any area of the body, but respiratory akathisia is an unusual type of akathisia. Cases of respiratory akathisia in cancer patients taking antiemetic drugs have not previously been reported.

Methods:

We report on a case of a cancer patient taking prochlorperazine as an antiemetic drug who experienced dyspnea accompanied by severe restlessness associated with respiration. By administration of biperiden, his restlessness in respiration and dyspnea promptly disappeared.

Results:

This finding led us to conclude that this cancer patient was experiencing respiratory akathisia.

Significance of results:

Respiratory akathisia is uncommon. It is important for cancer patients that dyspnea induced by disease progression be ruled out as a cause of the respiratory restlessness. It is necessary to consider the possibility of akathisia in patients that complain of vague anxiety, chest discomfort, or dyspnea following antipsychotic medication.

Type
Case Report
Copyright
Copyright © Cambridge University Press 2008

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References

REFERENCES

Bateman, D.N., Darling, W.M., Boys, R., et al. (1989). Extrapyramidal reactions to metoclopramide and prochlorperazine. Quarterly Journal of Medicine, 71, 307311.Google ScholarPubMed
Blaisdell, G.D. (1994). Akathisia: A comprehensive review and treatment summary. Pharmacopsychiatry, 27, 139146.CrossRefGoogle Scholar
Burris, H., Hesketh, P., Cohn, J., et al. (1996). Efficacy and safety of oral granisetron versus oral prochlorperazine in preventing nausea and emesis in patients receiving moderately emetogenic chemotherapy. The Cancer Journal from Scientific American, 2, 8590.Google ScholarPubMed
Crucitt, M.A., Hyman, W., Grote, T., et al. (1996). Efficacy and tolerability of oral ondansetron versus prochlorperazine in the prevention of emesis associated with cyclophosphamide-based chemotherapy and maintenance of health-related quality of life. Clinical Therapeutics, 18, 778788.CrossRefGoogle ScholarPubMed
Dressler, D. & Benecke, R. (2005). Diagnosis and management of acute movement disorders. Journal of Neurology, 252, 12991306.CrossRefGoogle ScholarPubMed
Esmail, Z., Montgomery, C., Courtrn, C., et al. (1999). Efficacy and complications of morphine infusions in postoperative paediatric patients. Paediatric Anaesthesia, 9, 321327.CrossRefGoogle ScholarPubMed
Fleishman, S.B., Lavin, M.R., Sattler, M., et al. (1994). Antiemetic-induced akathisia in cancer patients receiving chemotherapy. American Journal of Psychiatry, 151, 763765.Google Scholar
Gibb, W.R.G. & Lee, A. (1986). The clinical phenomenon of akathisia. Journal of Neurology, Neurosurgery, and Psychiatry, 49, 861866.CrossRefGoogle ScholarPubMed
Heard, K., Daly, F.F., O'Malley, G., et al. (1999). Respiratory distress after use of droperidol for agitation. Annals of Emergency Medicine, 34, 410411.CrossRefGoogle ScholarPubMed
Hirose, S. (2000). Restlessness of respiration as a manifestation of akathisia: Five case reports of respiratory akathisia. Journal of Clinical Psychiatry, 61, 737741.Google Scholar
Hirose, S. & Ashby, C.R. (2000). Intravenous biperiden in akathisia: An open pilot study. International Journal of Psychiatry in Medicine, 30, 185194.CrossRefGoogle ScholarPubMed
Kruk, J., Sachdev, P., Singh, S. (1995). Neuroleptic-induced respiratory dyskinesia. The Journal of Neuropsychiatry and Clinical Neurosciences, 7, 223229.Google ScholarPubMed
Matsui-Sakata, A., Ohtani, H., & Sawada, Y. (2005). Pharmacokinetic-pharmacodynamic analysis of antipsychotics-induced extrapyramidal symptoms based on receptor occupancy theory incorporating endogenous dopamine release. Drug Metabolism and Pharmacokinetics, 20, 187199.Google Scholar
Raskin, D.E. (1972). Akathisia: A side effect to be remembered. American Journal of Psychiatry, 129, 345347.CrossRefGoogle ScholarPubMed
Ratey, J.J. & Salzman, C. (1984). Recognizing and managing akathisia. Hospital and Community Psychiatry, 35, 975977.Google ScholarPubMed
Seeman, P. (2002). Atypical antipsychotics: Mechanism of action. Canadian Journal of Psychiatry, 47, 2738.Google Scholar
Tsuji, Y., Miyama, S., Uemura, Y., et al. (2006). Three cases of drug-induced akathisia due to antiemetics during cancer palliative care. Gan To Kagaku Ryoho, 33, 267269.Google Scholar
Walters, A.S., Hening, W., Chokroverty, S., et al. (1989). Restlessness of the arms as the principal manifestation of neuroleptic-induced akathisia [letter]. Journal of Neurology, 236, 435.Google Scholar