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Annals of Oncology 7:855-856, 1996
© 1996 European Society for Medical Oncology

brief-report

Rapid discontinuation of hypnotics in terminal cancer patients: A prospective study

E. Bruera1,, R. L. Fainsinger1, T. Schoeller1 and C. Ripamonti2

1Palliative Care Program, Edmonton General (Grey Nuns Community Health Centre), Division of Palliative Care Medicine, Universiry of Alberta Edmonton, AB, Canada
2Division of Palliative Care, National Cancer Institute Milan, Italy

Correspondence to: Dr. Eduardo Bruera Director Palliative Care Program Grey Nuns Community Health Centre 1100 Youville Drive West Edmonton, Alberta Canada T6L 5X8

PURPOSE:: To determine the proportion of patients receiving hypnotics upon admission to a palliative care unit, the frequency and intensity of withdrawal symptoms after rapid hypnotic discontinuation, and the effect of discontinuation on insomnia and cognitive failure.

PATIENTS AND METHODS:: 120 consecutive admitted patients. Rapid hypnotic discontinuation (1–4 days) was attempted. Insomnia (visual analogue 0 = best, 100 = worst for insomnia, restedness during the morning and difficulty falling asleep), cognition (Mini-Mental State Questionnaire), and withdrawal signs were monitored.

RESULTS:: Upon admission, 92/120 patients (77%) had been receiving hypnotics for a mean of 11 (standard deviation = 8) weeks. 4/92 patients (4%) refused hypnotic discontinuation. Acute mild withdrawal was observed in 2/88 patients (2%). The intensity of insomnia was not significantly different, while cognition significantly improved after hypnotic discontinuation.

CONCLUSIONS:: A large proportion of terminal cancer patients receives hypnotic drugs chronically. These drugs are probably not useful for the treatment of their insomnia, and rapid discontinuation can be safely achieved in most patients.

cancer, cognitive function, hypnotic, visual analogue scales


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