Psychotropic drug use in the patient with cancer is reviewed from the perspective of the practicing oncologist and the consulting psychiatrist. Guidelines are offered for use of psychotropic agents for specific symptoms, such as nausea and vomiting, pain control, treatment of depression, delirium, anxiety, and psychosis. The importance of careful assessment and treatment of the causes of psychiatric symptoms is stressed. Recommendations for use of specific psychotropic agents are reviewed, including dosage range and route of administration as well as possible drug interactions and other factors affecting the use of these agents in patients. Anecdotal uses of these agents are also considered.