Korean J Psychopharmacol.
2010 Apr;21(2):51-61.
Management of Depression in Terminally Ill Cancer Patients
- Affiliations
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- 1Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea. jmkim@chonnam.ac.kr
- 2Depression Clinical Research Center, Chonnam National University Hospital, Gwangju, Korea.
- 3Mental Health Clinic, Chonnam National University Hwasun Hospital, Hwasun, Korea.
- 4Department of Hematooncology, Chonnam National University Hwasun Hospital, Hwasun, Korea.
Abstract
- Depression is common in terminally ill cancer patients, and the management of depression in these patients is very important because this condition is associated with distress, suicidal ideation, and decreased quality of life. Antidepressants and psychostimulants are frequently used in the pharmacological treatment of depression in terminally ill cancer patients. The effectiveness of several Selective Serotonin Reuptake Inhibitors (SSRIs) for the treatment of depression in this population has been reported; however, such improvement only occurred approximately 2-4 weeks after the medications were initiated. Psychostimulants offer the advantage of rapid action, an especially important consideration given that terminally ill patients have a short life expectancy. Moreover, methylphenidate has been reported as reversing the sedating effect of opioids, decreasing fatigue, and reducing pain. However, the adverse effect of methylphenidate must be considered. Additionally, psychotherapy also seems to improve depression and anxiety. Members of the treatment teams delivering palliative care often experience emotional burnout. Because emotional burnout results in depression and depersonalization, psychological care for the treatment team is crucial. The end-of-life period of patients is very important because it is the time at which individuals review their lives. Management of the depression in these patients will improve their quality of life and contribute to resolving their end-of-life issues.
MeSH Terms
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Analgesics, Opioid
Antidepressive Agents
Anxiety
Depersonalization
Depression
Fatigue
Hospices
Humans
Imidazoles
Life Expectancy
Methylphenidate
Nitro Compounds
Palliative Care
Psychotherapy
Quality of Life
Serotonin Uptake Inhibitors
Suicidal Ideation
Terminally Ill
Analgesics, Opioid
Antidepressive Agents
Imidazoles
Methylphenidate
Nitro Compounds
Serotonin Uptake Inhibitors
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