Acute psychosis after paclitaxel infusion

Area of Science:

• Oncology
• Neuroscience
• Pharmacology

Background:

• Paclitaxel (PTX) is a crucial chemotherapy drug for various cancers.
• Common PTX side effects include myelosuppression and peripheral neurotoxicity.
• Central nervous system (CNS) toxicity is an infrequent but documented adverse effect of PTX.

Observation:

• A patient with laryngeal cancer developed transient mental status changes and psychosis.
• These neurological symptoms occurred after each cycle involving PTX and carboplatin.
• The symptoms resolved within a day after each PTX-containing treatment cycle.

Findings:

• Excluding PTX from the treatment regimen in a subsequent cycle led to the cessation of CNS symptoms.
• This suggests a potential causal link between paclitaxel and the observed acute neuropsychiatric events.
• The patient's reaction highlights a specific, albeit temporary, CNS toxicity profile associated with PTX.

Implications:

• This case underscores the importance of recognizing and reporting rare CNS side effects of paclitaxel.
• Further investigation may be warranted to understand the mechanisms of PTX-induced neuropsychiatric toxicity.
• Clinicians should consider PTX as a potential cause of acute mental status changes in cancer patients undergoing treatment.