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Support Care Cancer. 2016 Jun;24(6):2393-5. doi: 10.1007/s00520-016-3101-x. Epub 2016 Feb 2.

Use of olanzapine for the relief of nausea and vomiting in patients with advanced cancer: a multicenter survey in Japan.

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Department of Palliative Care Unit, JCHO Tokyo Shinjuku Medical Center, 5-1 Tsukudo-cyo, Shinjuku, Tokyo, 162-0815, Japan.
Department of Palliative Care, Shimada Hospital, Fukuoka, Japan.
Department of gastroenterological medicine, Tokyo Rinkai Hospital, Tokyo, Japan.
Seirei Hospice, Seirei Mikatahara General Hospital, Hamamatsu, Japan.
Hospice, Medical Corporation Junkei-kai Sotoasahikawa Hospital, Akita, Japan.
Department of Palliative Care, Japanese Red Cross Medical Center, Tokyo, Japan.
Department of Palliative Medicine, Showa University Northern Yokohama Hospital, Yokohama, Japan.
Department of Palliative Medicine, Shizuoka Saiseikai General Hospital, Shizuoka, Japan.
Department of Palliative Care, Nomura Hospital, Tokyo, Japan.
Department of Palliative Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
Department of Surgery and Palliative Care Team, Koto Hospital, Tokyo, Japan.
Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan.
Palliative and Supportive care Division, Seirei Mikatahara Hospital, Hamamatsu, Japan.
Department of Palliative Medicine, Institute of Medical Science, The University of Tokyo, Tokyo, Japan.


Nausea and vomiting are among the most common and distressing symptoms in patients with advanced cancer. Olanzapine, an antipsychotic agent, is known to have an affinity for multiple neurotransmitter receptors. Previous studies have reported olanzapine to be efficacious in the treatment of nausea and vomiting. Although it has been administered at a number of facilities, its applicability to treat nausea and vomiting in patients with advanced cancer is poorly understood. We investigated the use of olanzapine for nausea and vomiting in patients with advanced cancer at multiple centers. This retrospective study was carried out at seven palliative care units and three facilities with palliative care teams in Japan from 2013 to 2015. The dosage of olanzapine, treatment duration, and duration from initial use until death were collected from the medical records. One hundred and eight patients met our inclusion criteria. The average dose of olanzapine was 3.6 mg (2.5 mg, n = 61; 5 mg, n = 46; 10 mg, n = 1) and average treatment duration was 18.7 days. The average duration from initial use until death was 39.0 days. There were no differences in the duration of administration until death between olanzapine doses (2.5 and 5 mg). Our results suggest that olanzapine have been used in patients with poor prognoses for nausea and vomiting in patients with advanced cancer. Conducting a prospective trial would further yield promising results.


Cancer; Nausea; Olanzapine; Palliative care; Vomiting

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