What is prescription drug-induced nausea and vomiting?
Prescription drug-induced nausea and vomiting refers to the occurrence of nausea and vomiting as a result of taking certain medications prescribed by healthcare professionals. This side effect can be experienced by individuals who are undergoing various treatments or taking specific medications for medical conditions.
Nausea and vomiting are common adverse effects of many prescription drugs, including chemotherapy drugs, opioids, antibiotics, and certain psychiatric medications. These symptoms can significantly impact a patient's quality of life and may even lead to non-adherence with medication regimens.
Anticipatory nausea and chemotherapy-induced nausea and vomiting
One aspect of prescription-induced nausea is anticipatory nausea and vomiting (ANV) —a phenomenon where individuals experience nausea in anticipation of taking their medication, and is commonly developed in patients undergoing chemotherapy. Frequent exposure to chemotherapy increases the chance of experiencing ANV, and it is suggested that ANV may develop via classical conditioning. In other words, when a patient associates the treatment environment (e.g., clinic, hospital) with the unpleasant effects of chemotherapy, they may feel nauseous even before receiving the treatment. This mind-body duet can create a cycle of anxiety, further exacerbating the physical symptoms.
Similarly, another specific type of drug-induced nausea is chemotherapy-induced nausea and vomiting (CINV). As the name suggests, CINV refers to nausea and vomiting as a side effect of chemotherapy treatment experienced by cancer patients. The patient-reported prevalence of CINV is estimated to be in the 30% – 90% range. The fear and anxiety associated with the anticipation of these side effects can be overwhelming. Addressing CINV requires a comprehensive approach that goes beyond the physical symptoms, acknowledging the psychological toll it takes on patients.
Psychological interventions to mitigate prescription drug-induced nausea and vomiting
Psychological interventions can help alleviate nausea and vomiting induced by prescription drugs, including CINV. These interventions provide patients with effective coping strategies and support to manage these symptoms. For example, one systematic review by Samami et al. (2022) investigated the effects of cognitive behavioral therapy (CBT), progressive muscle relaxation (PMR), yoga, and guided imagery on the prevalence of chemotherapy-induced nausea and vomiting in women with breast cancer.
In 8 of the 9 examined studies, these interventions improved patients’ conditions and reduced the occurrence of chemotherapy-induced nausea and vomiting. CBT in particular helped reduce CINV through tools such as relaxation techniques, learning about coping strategies, and emotional support (Samami et al., 2022). Progressive muscle relaxation is a technique where patients tense and relax muscle groups in a specific order. This technique is derived from the premise that a state of mental calm is achieved through physical relaxation (McCallie et al., 2006).
Digital support for side-effect management
Digital health platforms are increasingly incorporating evidence-based psychological techniques like CBT to help patients manage and mitigate prescription drug-induced side effects, such as nausea and vomiting. Digitally delivered psychological support offers a convenient and accessible way for patients to engage with such interventions and content.
For example, patients can access interactive modules and tools as well as psycho-education that provides information on nausea and vomiting, its causes, and practice effective coping strategies. Internet-based CBT, also referred to as iCBT has the advantages of availability, reduced stigmatization and a lower threshold for seeking help.
Sources
McCallie, M. S., Blum, C. M., & Hood, C. J. (2006). Progressive muscle relaxation. Journal of human behavior in the social environment, 13(3), 51-66.
Samami, E., Shahhosseini, Z., Hamzehgardeshi, Z., & Elyasi, F. (2022). Psychological Interventions in Chemotherapy-Induced Nausea and Vomiting in Women with Breast Cancer: A Systematic Review. Iranian journal of medical sciences, 47(2), 95–106. https://doi.org/10.30476/ijms.2020.86657.1660
