Hypnotic Sedatives Anxiety is too often inappropriately treated with benzodiazepines rather than with discussion and support. The routine use of hypnotic sedatives is not encouraged, although assured, adequate sleep is important. One of the goals of using these medications is the diminishing of anxiety, but it is important to recognize that drugs should be combined with adequate psychotherapeutic intervention. Haloperidol seems to be preferred because it has a less sedating effect and fewer anticholinergic adverse effects. The phenothiazines have an antinausea effect that is frequently beneficial to cancer patients.
Anticipatory grief is a normal reaction and an integral component of a life-threatening illness.
When antidepressants are necessary, the tricyclic antidepressants or newer antidepressants may be chosen. Special consideration must be given to patients who have cardiac conduction disturbances, prostatic hypertrophy, or glaucoma because tricyclic antidepressants could complicate these conditions. Generally, they should initially be given as single daily doses of 10-75 mg, preferably at bedtime, with increases according to tolerance. Doses of 150-200 mg may be needed, but doses above these are required only in exceptional cases. Unfortunately, the antidepressants need to be used for 1-3 weeks before the total therapeutic effect can be observed.