Evaluation of Chemotherapy Related Mania in Cancer Patients

Abstract

Objective: This study aims to evaluate chemotherapy-related mania in cancer patients. Methods: The mania status of 153 cancer patients who received chemotherapy was compared by applying the Young Mania Rating Scale before starting chemotherapy and after one session of the chemotherapy regimen. Results: When the mania total scores before and after treatment were compared according to the chemotherapeutic agents, it was seen that the post-treatment mania total scores increased in those using Fluorouracil-Folinic Acid-Oxaliplatin (Folfox) (p=0.014) and paclitaxel (p=0.036) chemotherapy regimens. In 8 (5.2%) patients who received the Folfox regimen, the mild mania score exceeded 20 points. Conclusions: Although the blood-brain barrier protects the central nervous system from the toxicity of many drugs, it is known that the stress of cancer diagnosis and some chemotherapeutics used in treatment cause disorders such as acute confusion, depression, and mania. In our study, as in case-based publications in the literature, a statistically significant increase in the total mania score was found in the Folfox regimen due to 5-fluorouracil's ability to cross the blood-brain barrier easily. According to published case reports in the literature, the possibility of mania symptoms appearing in the second, third, and sometimes subsequent sessions should be taken into consideration due to cumulative or delayed side effects of the drugs.