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Medline ® Abstract for Reference 81

of 'Prevention and management of side effects in patients receiving opioids for chronic pain'

A retrospective chart review of the antiemetic effectiveness of risperidone in refractory opioid-induced nausea and vomiting in advanced cancer patients.
Okamoto Y, Tsuneto S, Matsuda Y, Inoue T, Tanimukai H, Tazumi K, Ono Y, Kurokawa N, Uejima E
J Pain Symptom Manage. 2007 Aug;34(2):217-22. Epub 2007 Jun 4.
Nausea and vomiting are distressing symptoms in advanced cancer patients. The causes of nausea and vomiting are multifactorial. Among the causes is opioid therapy, the mainstay of cancer pain management. When nausea or other opioid side effects occur, it may hamper pain management and undermine the quality of life of cancer patients. Risperidone exerts an antiemetic effect in animals, but there has been no clinical report on its antiemetic activity. We conducted a retrospective chart review to examine whether risperidone is useful for opioid-induced nausea and vomiting in advanced cancer patients (n=20). Risperidone was given as doses of 1mg once a day. Complete response was observed in 50% of patients (10/20) for nausea and 64% (7/11) for vomiting. Sedation (n=2) was documented as an adverse effect. This observation suggests that risperidone can be an effective antiemetic drug in the treatment of refractory opioid-induced nausea and vomiting in advanced cancer patients.
Department of Hospital Pharmacy Education, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan. okamoysh@phs.osaka-u.ac.jp