Current Practice of Intravenous and Subcutaneous Chlorpromazine for Sleep Disturbance in a Palliative Care Unit, with a Focus on Concomitant Use of Midazolam: A Retrospective Descriptive Study
- VernacularTitle:緩和ケア病棟における睡眠障害に対するクロルプロマジン静脈内・皮下投与の現状とミダゾラム併用状況：後方視的記述研究
- Author:
Misuzu CHO
1
;
Eiko TAMAI
2
;
Chisato FUKUHARA
1
;
Erina KUBO
1
;
Sayaka OZAKA
1
Author Information
- Keywords: chlorpromazine; midazolam; sleep disturbance; palliative care; retrospective study
- From:Palliative Care Research 2026;21(1):49-53
- CountryJapan
- Language:Japanese
- Abstract: Objective: This study retrospectively examined the practice of chlorpromazine (CPZ) administration for sleep disturbance in a palliative care unit, with particular attention to concomitant use of midazolam (MDZ). Methods: A total of 126 patients were reviewed. Among them, 98 patients who continued CPZ for three days or longer were evaluated for changes in nighttime sleep status using a sleep score and for daytime consciousness level. Results: MDZ was used concomitantly in 99 patients (78.5%). Adverse events related to CPZ were observed in 12 patients (9.5%), mainly oversedation and extrapyramidal symptoms, while no severe circulatory or respiratory suppression was noted. Among the 98 patients who received CPZ continuously for three days or longer, sleep scores showed an improving trend; however, some patients experienced decreased daytime alertness, and the possibility that adverse events were underestimated cannot be excluded. Conclusion: This study was a retrospective, single-center analysis based on medical records and therefore has limitations related to the subjectivity of assessment tools and clinical judgment. Further prospective studies using standardized evaluation scales are required to establish the efficacy and safety of CPZ for sleep disturbance.
