Strategic use of benzodiazepines in cancer patients.

Benzodiazepines have so many uses in cancer patients that the physician may target more than one advantage as he considers choice of drug and dose. Nausea, pain, and anxiety may be treated simultaneously. Since these patients are often taking a number of medications, the simplest regimen has the most benefit. These drugs treat reactive anxiety, insomnia, claustrophobia, and panic disorder. As they treat anticipatory anxiety and phobia, they mitigate anticipatory nausea and a component of post-treatment nausea. With chemotherapy itself, they cause sedation, suppress recall of treatment, limit vomiting, and are seen as desirable by patients. They suppress the restlessness associated with metoclopramide and other dopamine-antagonist antiemetics. The analgesic effects are best seen in conditions of high anxiety, muscle spasm, and deafferentation syndromes. The advantages of sedative and antipsychotic effects may be exploited to suppress the psychiatric complications of high-dose corticosteroids.