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Hallucinations and ifosfamide-induced neurotoxicity
J R DiMaggio1, R Brown, W F Baile
1Department of Psychiatry and Behavioral Medicine and Psychosocial Medicine, University of South Florida College of Medicine, Tampa.
Cancer
|March 1, 1994
Summary
Ifosfamide can cause hallucinations, a neurotoxicity symptom, even without other mental changes. These "eyes-closed" hallucinations in cancer patients may be the first sign of toxicity.
Area of Science:
- Oncology
- Neuroscience
- Pharmacology
Background:
- Ifosfamide is an alkylating agent used in chemotherapy.
- Neurotoxicity is a known side effect of ifosfamide, but hallucinations are poorly described.
- Hallucinations often occur with other mental status changes.
Observation:
- This study interviewed six patients receiving high-dose ifosfamide during bone marrow transplant.
- All patients experienced hallucinations with a clear sensorium.
- Hallucinations occurred exclusively when patients' eyes were closed.
Findings:
- Hallucinations can be the sole or initial symptom of ifosfamide-induced neurotoxicity.
- The incidence of hallucinations may be related to ifosfamide dosage and infusion duration.
- Patients often underreport these disturbing "eyes-closed" hallucinations.
Implications:
- Clinicians should be aware of the possibility of isolated ifosfamide-induced hallucinations.
- Patient education and support are effective for managing anxiety related to these hallucinations.
- Further research is needed to clarify optimal pharmacologic management for severe agitation.