The drug Zyprexa has proven effective in treating several symptoms and side effects in patients undergoing lung cancer treatment, such as cancer-related anorexia.

How does olanzapine work? The agent has an affinity for multiple neurotransmitter receptors, and many of these — the serotonin receptors 5HT2 and 5HT3, histamine receptors, and dopamine receptors — are involved in anorexia, nausea, and vomiting.

In an outline of the various pharmacotherapy options for lung cancer patients, psychiatrist R. Garrett Key, MD, now of Seton Behavioral Health Care Cancer Care Collaborative in Austin, Tex., suggested olanzapine, 2.5-10 mg daily, as helpful for anxiety, with additional benefits for sleep, nausea, and appetite.

In a phase III trial, Rudolph Navari, MD, PhD, of the University of Notre Dame in South Bend, Ind., and colleagues tested the efficacy of olanzapine for preventing nausea and vomiting in patients receiving highly emetogenic chemotherapy, against placebo. The antipsychotic was paired with dexamethasone, aprepitant, or fosaprepitant, and a 5-hydroxytryptamine type 3–receptor antagonist.

Among the 380 evaluable patients, about 13% had primary disease in the lungs, and of those, 14% were in the olanzapine arm. These chemotherapy-naïve patients received cisplatin at 70 mg/m2 of body-surface area, or cyclophosphamide-doxorubicin. The study groups received either 10 mg of olanzapine orally or matching placebo daily on days 1 through 4. The primary endpoint was nausea prevention.

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