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Noradrenergic activity in anticipatory nausea
J H Fetting1, M E Stefanek, V R Sheidler
1Johns Hopkins Oncology Center, Baltimore, MD 21287.
Psychosomatic Medicine
|November 1, 1992
Summary
This study investigated if noradrenergic activity causes anticipatory nausea in cancer patients. Results showed elevated MHPG but clonidine provided only marginal relief, suggesting noradrenergic activity is not a primary cause.
Area of Science:
- Neuroscience
- Oncology
- Pharmacology
Background:
- Anticipatory nausea is a common side effect of cancer chemotherapy.
- Noradrenergic activity has been hypothesized to play a role in its development.
Purpose of the Study:
- To investigate the role of noradrenergic activity in chemotherapy-induced anticipatory nausea.
- To evaluate the efficacy of clonidine, a noradrenergic-inhibiting agent, in treating anticipatory nausea.
Main Methods:
- Two studies were conducted: an observational study measuring plasma MHPG (3-methoxy-4-hydroxyphenyl-glycol) and a randomized, double-blind, placebo-controlled, crossover trial of clonidine.
- Plasma MHPG levels were assessed in patients with and without anticipatory nausea.
- Clonidine was administered to assess its effect on anticipatory nausea and MHPG levels.
Main Results:
- Patients experiencing anticipatory nausea had significantly higher plasma MHPG concentrations.
- Clonidine treatment led to significant side effects and reduced plasma MHPG levels.
- However, clonidine only marginally improved anticipatory nausea symptoms.
Conclusions:
- Elevated MHPG levels suggest a correlation between noradrenergic activity and anticipatory nausea.
- The limited efficacy of clonidine indicates that noradrenergic activity is not a primary causative factor for anticipatory nausea.
- Clonidine does not appear to have an acceptable therapeutic index for managing anticipatory nausea.