Pharmacotherapy of Depression in People with Cancer

Grassi, Luigi; Nanni, Maria Giulia; Uchitomi, Yosuke; Riba, Michelle

doi:10.1002/9780470972533.ch7

Cited by 15 publications

(18 citation statements)

References 102 publications

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“…Recent meta analysis[37] and guidelines for psychopharmacology[38] highlight the advances in this field. The role of psychological treatments in the management of psychological problems is not doubted by physicians and surgeons.…”

Section: Discussionmentioning

confidence: 99%

Psychiatric oncology: Cancer in mind

Chaturvedi

2012

Indian J Psychiatry

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Psychosocial oncology is an upcoming area of interest, which deals with numerous psychiatric, psychological, and social aspects of malignancies. Psychiatric oncology relates to some of the common psychological and emotional problems encountered in persons with malignancy and their formal and informal caregivers. This oration will discuss the importance of this field of Consultation Liaison Psychiatry, with a focus on the research and practice in the Indian setting. This presentation will also share the findings and researches of the presenter. All these range from studies on cancer pain and palliative care, screening for psychiatric morbidity, quality of life, communication skills for health professionals in breaking bad news and handling difficult questions, and counseling. The findings on researches on somatization and illness behavior in cancer patients would highlight newer challenges in this field. Caregivers of persons with cancer are as important as the patient, but usually ignored. The stress, strain, burden, positive emotions, and coping in the context of care giving for persons with cancer are being increasingly realized. Professional caregivers should be aware of caregiver difficulties and support them through their ordeal. Lastly, the importance of dealing with staff stress and burnout among health professionals looking after families with cancer patients and survivors will be emphasized.

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Section: Discussionmentioning

confidence: 99%

Psychiatric oncology: Cancer in mind

Chaturvedi

2012

Indian J Psychiatry

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“…Pharmacology 2011;88:333-339 334 oped with the purpose of promoting and conciliating psychopharmacological and psychosocial treatments, and highlighting the need of evaluating and treating depression in cancer patients [2,8,9] .…”

Section: Miguel /Albuquerquementioning

confidence: 99%

“…In fact, the use of antidepressants (ADs) in cancer patients has increased in the last 20-25 years [2,10] , and is recommended in the treatment of severe to moderate major depression [11] . Yet, the evidence does not support the supremacy of one AD over the other or a pharmacological treatment over a psychosocial one [11] .…”

Section: Miguel /Albuquerquementioning

confidence: 99%

Drug Interaction in Psycho-Oncology: Antidepressants and Antineoplastics

Miguel

Albuquerque

2011

Pharmacology

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Background and Objectives: Although there is a growing impact of psychiatric and depressive disorders in cancer patients, literature on the idiosyncrasies of antidepressants (ADs) used in those conditions and their interactions with antineoplastic agents (ANs) is scarce. Sharing the same biotransformation pathways enhances the risk of drug interaction between ADs and ANs, specifically when compounds are inducers, inhibitors or substrates of cytochrome P450 (CYP 450). In cancer patients, such drug interactions may result in less efficacy of the drug and/or increase of their side effects. Therefore, the choice of AD should be cautious (safe and effective) and well supported. The main purpose of this review was to analyze the individual pharmacokinetic properties of the most used ADs and ANs in order to summarize the risk of possible drug interactions between them, anticipating the consequences of their coadministration. Methods: The authors reviewed books and PubMed online articles published in the last 6 years. Results: Most of the ANs are subject to transformation by CYP 450 3A4 and their coadministration with ADs, that have inhibitory properties of this CYP isoform, such as fluoxetine, sertraline, paroxetine and fluvoxamine, may result in the loss of the AN’s efficacy or higher toxicity. Conclusion: Among the ADs, escitalopram, citalopram, venlafaxine, mirtazapine and milnacipran stand out for their weak CYP 450 inhibitory potential and their safety profile in those patients.

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“…Antidepressant therapy tailored to the symptom profile can treat major depression in the presence of cancer, and can also relieve some of the other common symptoms experienced with cancer (anxiety, insomnia, anorexia, nausea, agitation, fatigue, loss of motivation, pain, pruritus and hot flushes). 21,22 The evidence base for the use of particular antidepressants in cancer, particularly in the palliative care setting, is not strong, due to the paucity of research. 23,24 In choosing from a range of equally effective second-generation antidepressants, 25 psychiatrists in specialist psycho-oncology services take into consideration the patient's symptom profile, ambulatory versus palliative care status, comorbid illnesses, desired and undesired drug side effects, and potential drug interactions.…”

Section: Psychotropic Use In Cancermentioning

confidence: 99%