Noradrenergic activity in anticipatory nausea
- Author(s): Fetting, JH
- Stefanek, ME
- Sheidler, VR
- Elsworth, JD
- Piantadosi, S
- Roth, RH
- et al.
Published Web Locationhttp://ovidsp.tx.ovid.com/sp-3.23.1b/ovidweb.cgi?QS2=434f4e1a73d37e8c8b3eab7e2fc8fd7c3c8eb6b4092c40068c6a3776e5aa31a8f99472517b2d20e10e0300d41d74f4d278e37afaaef3337979d041ff90b61a8eaaa73d46fa32ffe27095bc5ed75fed0e9cb5ccbac640283993481890df104c13a16c380764b04818d7ede21cc9e8bda28bed08def7a1db8d5394d360323e1970d7d53b3b38a771439744b14790f01e2fd29ed07bd904ac2ecd911a9c92f6463f1b87efa994e5842d8747e65fa76866e8ecf32b5c4b9df0c9e1e45458a20683393d993555f89ba34924716191bb6bacbec6427e47604a5f0bc4eee161c8ea8e9
Two studies were conducted to examine the hypothesis that noradrenergic activity is a cause of the anticipatory nausea associated with cancer chemotherapy. In the first study concentrations of plasma 3-methoxy-4- hydroxyphenyl-glycol (MHPG) on day 1 of cycle 5 of initial chemotherapy were significantly higher in patients with than without anticipatory nausea. To determine whether elevated MHPG reflected a clinically significant causative role for noradrenergic activity in anticipatory nausea, we conducted a randomized, double-blind, placebo-controlled, crossover trial of clonidine for anticipatory nausea. At a dose of clonidine that produced significant side effects and reductions of plasma MHPG, anticipatory nausea was improved only marginally. These studies do not support a causative role for noradrenergic activity in anticipatory nausea that can be reduced by clonidine with an acceptable therapeutic index.
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