Antiemetic efficacy of alprazolam in the combination of metoclopramide plus methylprednisolone. Double-blind randomized crossover study in patients with cisplatin-induced emesis.

The usefulness of alprazolam (minor tranquilizer) used in combination with metoclopramide plus methylprednisolone for the prevention and control of emesis induced by chemotherapies, including 5-day continuous intravenous infusion of cisplatin (25 mg/m2/day) for advanced lung cancer, was evaluated using a double-blind randomized crossover design. In our study, 34 cases could be evaluated. No nausea was observed in 14 patients given alprazolam and 4 placebo (p < .01). The mean number of vomiting episodes was significantly smaller in the alprazolam group (1.31 +/- 2.61 vs 2.89 +/- 4.59 times) (p < .01). The mean duration of nausea and vomiting was significantly shorter in the alprazolam group (p < .001 and p < .01). From these findings, it can be concluded that the coadministration of alprazolam is effective in preventing and controlling chemotherapy-induced emesis due to 5-day continuous intravenous infusion of cisplatin in which mental and psychological factors are involved.