Pharmacotherapy of Depression in Cancer Patients

Pharmacotherapy is an important component of treatment for more severe and persistent depression in patients with cancer and advanced disease. The initiation of such treatment should follow a careful diagnostic assessment, and the choice of an antidepressant should be based upon the symptom profile of the patient, the antidepressant side-effect profile, and the least potential for interaction with chemotherapy and other medications. Although an antidepressant medication with a rapid onset of action is desirable in this population, psychostimulants and other such agents have not been shown to be effective. Psychotherapy should typically be provided in conjunction with pharmacotherapy and, in the case of minor depression, may be the sole therapeutic modality. This includes attentive psychoeducation on common concerns about antidepressants expressed by medical patients, in order to ensure safety and enhance compliance.