HALOPERIDOL CURES COGNITIVE DYSFUNCTION; THE MECHANISM OF ACTION IS EXPLAINED.
(Abstract release date: 05/21/15)
EHA Library. Hoef M. 06/12/15; 102625; PB1979
Disclosure(s): Transplant Creations
Marlies Hoef
Contributions
Contributions
Abstract
Abstract: PB1979
Type: Publication Only
Background
Cognitive disorders occur in the course of life threatening situations such as deportation and diseases such as cancer and are often associated with acute stress and post traumatic stress disorders induced by the treatment received. A battery of function tests have been used to assess cognitive disorders but cure for these disorders is not known.
Aims
Cognitive dysfunction has been reported after cancer treatment and after hematopoietic stem cell transplantation. The observations in this case lecture how to proceed in patients with similar conditions in the treatment of cancer.
Methods
Case
The subject experienced a life changing situation of major impact that induced a cognitive disorder, which expressed itselves in difficulty writing letters, documents and composing presentations; moreover she reported her capacity after deportation to be 10% of her former capacity (1). At a conference in 2013 a video was presented of a patient who had been treated for breast cancer who had the same cognitive disorder, being difficulty writing.
Results
Treatments that impact life drastically induce stress that may result in acute stress disorders, posttraumatic stress disorders and cognitive impairment. The subject was initially not treated and noticed slow improvement; however the old level of functioning was not reached and work finally resulted in burnout. Although time off work improved the status it was not until haloperidol was instated that she noticed improvement of writing skills after about three weeks of treatment. A few years later upon new exposure to stress she noticed a decrease in capacity that could not be overcome with rest and requested reinstatement of haloperidol. She reported recovery in about three weeks after start of therapy.
The subject first received haloperidol at a dose of 5 mg/day which was too high and induced extrapyramidal side effects. The dose was reduced to 2 mg/day, which was well tolerated. Although the subject had been advised to take the drug life long she stopped after nine to ten months and remained well. The second time haloperidol was prescribed at 2 mg/day and well tolerated and the function recovered in about three weeks. The subject took the drug four months and alternated 2 mg and 1 mg every other day. Since stopping the subject‘s status has remained well.
Summary
Biochemical studies have demonstrated that stress increases dopamine turn over in the prefrontal cortex, which is associated with cognitive deficits (2). Haloperidol is a dopamine receptor antagonist and administration reverses cognitive impairment.Van Hoef MEHM. Successful treatment of stress induced cognitive impairment with haloperidol; evaluation also warranted in hematopoietic stem cell transplantation.
The observations described hereabove warrant evaluation of haloperidol as treatment for cognitive disorders that may develop in the course of treatment for cancer; although these are generally attributed to chemotherapy, the mechanism of action may rather be attributable to stress induced biochemical changes in the brain.
In prescription of the drug, doctors should inform the recipient what to expect from the drug, that treatment is temporary, that they can relapse and that at a dose of 2 mg/day driving capacity is affected.
Referencea: 1) Van Hoef MEHM. Hematology and Leukemia 2015; doi 10.7243/2052-434X-3-1.
2) Amsten AF, Goldman-Rakic PS. Arch Gen Psychiatry 1998;55(4):362-8.
Keyword(s): Quality of life
Session topic: Publication Only
Type: Publication Only
Background
Cognitive disorders occur in the course of life threatening situations such as deportation and diseases such as cancer and are often associated with acute stress and post traumatic stress disorders induced by the treatment received. A battery of function tests have been used to assess cognitive disorders but cure for these disorders is not known.
Aims
Cognitive dysfunction has been reported after cancer treatment and after hematopoietic stem cell transplantation. The observations in this case lecture how to proceed in patients with similar conditions in the treatment of cancer.
Methods
Case
The subject experienced a life changing situation of major impact that induced a cognitive disorder, which expressed itselves in difficulty writing letters, documents and composing presentations; moreover she reported her capacity after deportation to be 10% of her former capacity (1). At a conference in 2013 a video was presented of a patient who had been treated for breast cancer who had the same cognitive disorder, being difficulty writing.
Results
Treatments that impact life drastically induce stress that may result in acute stress disorders, posttraumatic stress disorders and cognitive impairment. The subject was initially not treated and noticed slow improvement; however the old level of functioning was not reached and work finally resulted in burnout. Although time off work improved the status it was not until haloperidol was instated that she noticed improvement of writing skills after about three weeks of treatment. A few years later upon new exposure to stress she noticed a decrease in capacity that could not be overcome with rest and requested reinstatement of haloperidol. She reported recovery in about three weeks after start of therapy.
The subject first received haloperidol at a dose of 5 mg/day which was too high and induced extrapyramidal side effects. The dose was reduced to 2 mg/day, which was well tolerated. Although the subject had been advised to take the drug life long she stopped after nine to ten months and remained well. The second time haloperidol was prescribed at 2 mg/day and well tolerated and the function recovered in about three weeks. The subject took the drug four months and alternated 2 mg and 1 mg every other day. Since stopping the subject‘s status has remained well.
Summary
Biochemical studies have demonstrated that stress increases dopamine turn over in the prefrontal cortex, which is associated with cognitive deficits (2). Haloperidol is a dopamine receptor antagonist and administration reverses cognitive impairment.Van Hoef MEHM. Successful treatment of stress induced cognitive impairment with haloperidol; evaluation also warranted in hematopoietic stem cell transplantation.
The observations described hereabove warrant evaluation of haloperidol as treatment for cognitive disorders that may develop in the course of treatment for cancer; although these are generally attributed to chemotherapy, the mechanism of action may rather be attributable to stress induced biochemical changes in the brain.
In prescription of the drug, doctors should inform the recipient what to expect from the drug, that treatment is temporary, that they can relapse and that at a dose of 2 mg/day driving capacity is affected.
Referencea: 1) Van Hoef MEHM. Hematology and Leukemia 2015; doi 10.7243/2052-434X-3-1.
2) Amsten AF, Goldman-Rakic PS. Arch Gen Psychiatry 1998;55(4):362-8.
Keyword(s): Quality of life
Session topic: Publication Only
Abstract: PB1979
Type: Publication Only
Background
Cognitive disorders occur in the course of life threatening situations such as deportation and diseases such as cancer and are often associated with acute stress and post traumatic stress disorders induced by the treatment received. A battery of function tests have been used to assess cognitive disorders but cure for these disorders is not known.
Aims
Cognitive dysfunction has been reported after cancer treatment and after hematopoietic stem cell transplantation. The observations in this case lecture how to proceed in patients with similar conditions in the treatment of cancer.
Methods
Case
The subject experienced a life changing situation of major impact that induced a cognitive disorder, which expressed itselves in difficulty writing letters, documents and composing presentations; moreover she reported her capacity after deportation to be 10% of her former capacity (1). At a conference in 2013 a video was presented of a patient who had been treated for breast cancer who had the same cognitive disorder, being difficulty writing.
Results
Treatments that impact life drastically induce stress that may result in acute stress disorders, posttraumatic stress disorders and cognitive impairment. The subject was initially not treated and noticed slow improvement; however the old level of functioning was not reached and work finally resulted in burnout. Although time off work improved the status it was not until haloperidol was instated that she noticed improvement of writing skills after about three weeks of treatment. A few years later upon new exposure to stress she noticed a decrease in capacity that could not be overcome with rest and requested reinstatement of haloperidol. She reported recovery in about three weeks after start of therapy.
The subject first received haloperidol at a dose of 5 mg/day which was too high and induced extrapyramidal side effects. The dose was reduced to 2 mg/day, which was well tolerated. Although the subject had been advised to take the drug life long she stopped after nine to ten months and remained well. The second time haloperidol was prescribed at 2 mg/day and well tolerated and the function recovered in about three weeks. The subject took the drug four months and alternated 2 mg and 1 mg every other day. Since stopping the subject‘s status has remained well.
Summary
Biochemical studies have demonstrated that stress increases dopamine turn over in the prefrontal cortex, which is associated with cognitive deficits (2). Haloperidol is a dopamine receptor antagonist and administration reverses cognitive impairment.Van Hoef MEHM. Successful treatment of stress induced cognitive impairment with haloperidol; evaluation also warranted in hematopoietic stem cell transplantation.
The observations described hereabove warrant evaluation of haloperidol as treatment for cognitive disorders that may develop in the course of treatment for cancer; although these are generally attributed to chemotherapy, the mechanism of action may rather be attributable to stress induced biochemical changes in the brain.
In prescription of the drug, doctors should inform the recipient what to expect from the drug, that treatment is temporary, that they can relapse and that at a dose of 2 mg/day driving capacity is affected.
Referencea: 1) Van Hoef MEHM. Hematology and Leukemia 2015; doi 10.7243/2052-434X-3-1.
2) Amsten AF, Goldman-Rakic PS. Arch Gen Psychiatry 1998;55(4):362-8.
Keyword(s): Quality of life
Session topic: Publication Only
Type: Publication Only
Background
Cognitive disorders occur in the course of life threatening situations such as deportation and diseases such as cancer and are often associated with acute stress and post traumatic stress disorders induced by the treatment received. A battery of function tests have been used to assess cognitive disorders but cure for these disorders is not known.
Aims
Cognitive dysfunction has been reported after cancer treatment and after hematopoietic stem cell transplantation. The observations in this case lecture how to proceed in patients with similar conditions in the treatment of cancer.
Methods
Case
The subject experienced a life changing situation of major impact that induced a cognitive disorder, which expressed itselves in difficulty writing letters, documents and composing presentations; moreover she reported her capacity after deportation to be 10% of her former capacity (1). At a conference in 2013 a video was presented of a patient who had been treated for breast cancer who had the same cognitive disorder, being difficulty writing.
Results
Treatments that impact life drastically induce stress that may result in acute stress disorders, posttraumatic stress disorders and cognitive impairment. The subject was initially not treated and noticed slow improvement; however the old level of functioning was not reached and work finally resulted in burnout. Although time off work improved the status it was not until haloperidol was instated that she noticed improvement of writing skills after about three weeks of treatment. A few years later upon new exposure to stress she noticed a decrease in capacity that could not be overcome with rest and requested reinstatement of haloperidol. She reported recovery in about three weeks after start of therapy.
The subject first received haloperidol at a dose of 5 mg/day which was too high and induced extrapyramidal side effects. The dose was reduced to 2 mg/day, which was well tolerated. Although the subject had been advised to take the drug life long she stopped after nine to ten months and remained well. The second time haloperidol was prescribed at 2 mg/day and well tolerated and the function recovered in about three weeks. The subject took the drug four months and alternated 2 mg and 1 mg every other day. Since stopping the subject‘s status has remained well.
Summary
Biochemical studies have demonstrated that stress increases dopamine turn over in the prefrontal cortex, which is associated with cognitive deficits (2). Haloperidol is a dopamine receptor antagonist and administration reverses cognitive impairment.Van Hoef MEHM. Successful treatment of stress induced cognitive impairment with haloperidol; evaluation also warranted in hematopoietic stem cell transplantation.
The observations described hereabove warrant evaluation of haloperidol as treatment for cognitive disorders that may develop in the course of treatment for cancer; although these are generally attributed to chemotherapy, the mechanism of action may rather be attributable to stress induced biochemical changes in the brain.
In prescription of the drug, doctors should inform the recipient what to expect from the drug, that treatment is temporary, that they can relapse and that at a dose of 2 mg/day driving capacity is affected.
Referencea: 1) Van Hoef MEHM. Hematology and Leukemia 2015; doi 10.7243/2052-434X-3-1.
2) Amsten AF, Goldman-Rakic PS. Arch Gen Psychiatry 1998;55(4):362-8.
Keyword(s): Quality of life
Session topic: Publication Only
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