Psychotropic drugs

Psychotropic drugs are relevant in the treatment of many psychiatric disorders and/or symptoms in palliative medicine. This chapter focuses on two important groups of drugs, namely antipsychotics and cannabinoids. Antipsychotics have evolved in the last 10 years, with the release of new compounds with less side effects and more specific action for the treatment of disorders with psychotic features, including hallucinations, thought disorders and delusion. In palliative medicine these disorders usually include delirium, brief psychotic reactions, psychotic depression, or psychotic disorders due to medical cause (e.g. brain tumors) or drugs (e.g. corticosteroids, chemotherapeutic agents). The treatment include both first generation, called also typical or conventional antipsychotics, and second generation, or atypical antipsychotics. Both are also used in the adjuvant treatment of other symptoms such as nausea and vomiting or pain resisting to conventional intervention. Furthermore, the effectiveness of antispychotics in terminal sedation and in relieving severe, refractory physical symptoms in terminally ill patients has been repeatedly reported. Cannabinoids have recently come to the attention in medicine for their possible use in several clinical settings, such as mood and anxiety disorders, movement disorders such as Parkinson's and Huntington's disease, neuropathic pain, multiple sclerosis and spinal cord injury, cancer, atherosclerosis, myocardial infarction, stroke, hypertension, glaucoma, obesity/metabolic syndrome, and osteoporosis, due to the modulating activity of the endocannabinoid system