Psychotropic Medications in Palliative Care

Palliative care, as both a movement and a medical subspecialty, has grown over time from a small hospice movement focusing on the care of the actively dying to a clinical specialty focusing on symptom control and provision of support to those living with chronic, life-threatening illnesses in addition to those at the end of their lives.1 Given the burden of disease these patients face, it is perhaps not surprising that psychological symptoms such as depression, anxiety, and hopelessness are as frequent, if not more so, than other target symptoms such as pain.1 Inversely, perhaps in part due to their proximity to mental suffering and its treatment, practitioners of this discipline have long used psychotropic medications for a variety of symptoms, both in traditional and novel ways. However, the evidence upon which some of these practices rest are variable and at times appear more historic than supported by either accumulated clinical experience or empirical evidence. The following is a brief review of some of the ways that psychotropic medications are being used in palliative care and the evidence upon which their use rests.