Cancer-Related Depression and Potential Pharmacologic Therapies (Pharmacology Notes‪)‬

Depression in stem-cell transplant and chemotherapy-treated oncology patients has received increased attention in psychooncology research during the past decade. Depression is believed to negatively impact quality of life, long-term psychological adjustment, and survival rates. With the occurrence of depression in oncology patients reaching 15%-2 to 3 times greater than in the general population--improved diagnostic methods are needed, as well as interventions that are both timely and effective (1). Patients and health care providers may be reluctant to initiate therapy, as many of the symptoms can be explained as natural responses to the diagnosis and treatment of cancer. Physical depressive symptoms (e.g., sleep and appetite disturbances, psychomotor retardation, decreased energy) are common in oncology patients and act as confounders to such early diagnoses. Studies of hematopoietic stem cell transplant patients show that physical limitations peak around 90 days after transplant and improve about 1 year after transplant but do not significantly change throughout the 3- to 5-year full-recovery process. Physical recovery often occurs before emotional stability, yet complete recovery is a slow process that may worsen before improving. Further stem cell study results show that during a 5-year time period, 22% of patients report symptoms consistent with clinical depression, and an additional 31% could be classified as having mild depression (2).