Review article : Depression and the use of antidepressants in patients with cancer

Abstract

Depressive disorders are common sequelae of cancer and its treatment. Fortunately, most of them are transient and respond to information, adequate explanation and emotional support from those involved in patient care. This article concentrates on the less common but more severe depressive disorders which require pharmacological strategies in addition to psychosocial interventions. Guidelines are suggested for identifying depressive disorders and the importance of ruling out potentially reversible organic pathology which may be responsible for the mood disturbance is also emphasized. Estimates of the prevalence of depressive disorders among cancer patients are provided and practical advice is offered on the choice of antidepressant, dosage and side-effects.

Psychiatric disorder in a palliative care unit

“…Patients may not bring these emotions to the attention of the staff for a variety of reasons, such as fear that they are`losing their mind' or are`going insane' or that nothing else can be done. 18,19 Kubler-Ross's stages of dying are widely taught in medical schools and may be misused by doctors as a prescription for dying. 20 The patients are expected to pass from one stage to another in sequence.…”