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Published: 2019-08-07

Usage of antidepressants in cancer patients

Hospital of Israeli Oncology "LISOD"
Department of Psychiatry, Psychotherapy and Medical Psychology, Shupyk National Medical Academy of Postgraduate Education
antidepressants oncology cancer cancer symptoms drug interaction depression

Abstract

Background: Approximately one million cancer patients live in Ukraine. These persons are at a high risk of manifestation of psychiatric disorders, especially depressive spectrum disorders and anxiety disorders, which may be treated with antidepressants if indications are present. Besides, oncological patients suffer from a number of miscellaneous somatic and psychosomatic conditions, that may also be totally or partly alleviated by using antidepressants. Thus, proper safe and evidence-based usage of these drugs is required. Unfortunately, there’s a lack of Ukrainian scientific literature highlighting this issue. This review is published to fulfill the aforementioned gap.

Objectives: To survey the usage of antidepressants in the cohort of cancer patients, to evaluate a modern state of evidence base concerning this issue, and to study indications, contraindications, and other peculiarities in respect of prescribing these drugs to oncological patients. 

Methods: We reviewed and analyzed literature (meta-analyses, RTCs, observational studies, case studies) published in the last 10 years by searching PubMed and Google Scholar. We used the following keywords: “antidepressants”, “oncology”, “cancer”, “cancer symptoms”, “depression” and “drug interaction”. For our purposes, we also used NCCN, ASCO, ESMO, IPOS guidelines in case they were available and concerned our subject.

Results: The review focuses attention on the usage of antidepressants in oncological patients. Best-practice recommendations for choosing a drug are given, information on a drug-to-drug interaction with chemotherapy and other common in oncology drugs, issues with regard to comorbid somatic problems that define prescribing, and off-label indications (pain, hot flushes, pruritus, etc.) are discussed. 

Conclusion: Despite the paucity of high-quality researches, a huge amount of evidences support the statement, that antidepressants significantly improve cancer patients’ quality of life by ceasing both depressive/anxious symptoms and typical cancer-related symptoms. To provide best professional help with these drugs, implementation of guidelines recommendations as well as adherence to experience collected from prescribing antidepressants to non-cancer population, which supports the effectiveness of this class of drugs for the treatment of depression, anxiety and pain are essential. 

Full-text of the article is available for this locale: Українська.

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