Antidepressants for depression in medical illness

Gill, David; Hatcher, Simon

doi:10.1002/14651858.cd001312.pub2

Cited by 84 publications

(61 citation statements)

References 25 publications

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“…Nos últimos anos, o tratamento dos transtornos psiquiátri-cos em pacientes com câncer foi ampliado, com maior disponibilidade de psicofármacos, que, além de aliviar sintomas psicológicos, melhoram a náusea, o vômito, a dor e a fadiga que frequentemente acompanham o câncer 7,37 . Por outro lado, os efeitos colaterais como sedação, ganho de peso ou aqueles medicamentos cujo perfil de atuação tenha efeitos antináusea (afinidade com receptores 5HT2, 5HT3 e H1) ou antidor (sistemas serotoninérgicos e noradrenérgicos) podem orientar a escolha dos antidepressivos.…”

Section: Suicídiounclassified

Depressão e câncer

Bottino¹,

Fráguas

Gattaz

2009

Rev. psiquiatr. clín.

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ResumoA depressão é o transtorno psiquiátrico mais comum em pacientes com câncer, com prevalências variando de 22% a 29%. Essa variabilidade está associada a sítios do tumor, estágio clínico, dor, funcionamento físico limitado, além da existência de suporte social. A depressão associa-se a um pior prognóstico e aumento da mortalidade pelo câncer. Síndromes depressivas podem ser uma consequência das terapias antineoplásicas, como ocorre em 21% a 58% dos pacientes recebendo interferon-alfa. Sentimentos de tristeza e desespero podem inibir a procura de cuidado pelos pacientes, dificultando o reconhecimento da depressão. O tratamento com antidepressivos é efetivo e melhora a adesão aos tratamentos do câncer, reduzindo efeitos adversos como náusea, dor e fadiga. Em pacientes com câncer, tratamento prévio com antidepressivos pode minimizar sintomas depressivos induzidos por interferon-alfa. O tratamento com antidepressivos parece ser uma estratégia efetiva para prevenir o desenvolvimento da depressão induzida por interferon-alfa. Intervenções psicossociais, como técnicas de relaxamento, terapia individual e em grupo, também podem ser utilizadas na redução dos sintomas depressivos e de estresse em pacientes com câncer. Bottino SMB, et al. / Rev Psiq Clín. 2009;36(3):109-15Palavras-chave: Depressão, câncer, diagnóstico, tratamento. AbstractDepression is the most common psychiatric disorder in patients with cancer, with prevalence rates ranging from 22% to 29%. This variability is associated to cancer sites, clinical stages, pain, limited physical functioning, beyond the existence of social support. Depression is associated to poorer prognosis and higher cancer mortality. Depressive syndromes can be a consequence of the antineoplasic therapies, as occurs in 21% to 58% of the patients treated with alfa-interferon. Sadness and desperation can inhibit the search for care by the patients, and difficult depression recognition. Antidepressant treatment is effective, and improve the adherence to cancer treatments, reducing side effects as nausea, pain and fatigue. In cancer patients, pretreatment with antidepressants seems to minimize depressive symptoms induced by interferon-alfa. Psychosocial interventions as relaxing techniques, group and individual psychotherapies can also be applied to reduce depressive and stress symptoms in patients with cancer.Bottino SMB, et al. / Rev Psiq Clín. 2009;36(3):109-15

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Section: Suicídiounclassified

Depressão e câncer

Bottino¹,

Fráguas

Gattaz

2009

Rev. psiquiatr. clín.

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“…The SADHART trials suggest that sertraline is non-cardiotoxic even in patients recovering from myocardial infarction (Glassman 2002). A Cochrane review found that antidepressants improved the outcome in medically ill patients with depression (Gill 2000).…”

Section: Is the Treatment Of Depression Contributing To Increased Mormentioning

confidence: 99%

“…There is little doubt that treating depression in people with concurrent medical illness reduces morbidity (Gill 2000;MacHale 2002) but does it reduce mortality? The intuitive answer is 'Yes, of course', particularly as SSRIs may restore reduced heart-rate variability and attenuate platelet activation (Serebruany 2003) in depression, i.e.…”

Section: Does Treating Depression Reduce Mortality?mentioning

confidence: 99%

Depression, cardiac mortality and all-cause mortality

Seymour¹,

Benning²

2009

Adv. psychiatr. treat

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SUMMARYDepression is an illness that kills. The links between depression and medical illness are well established and bi-directional, but evidence is mounting that depression increases mortality as well as morbidity in adults, particularly older adults. We examine the evidence that the increase in mortality in depression applies to all-cause mortality as well as cardiac mortality, and describe plausible physiological theories for the association. We conclude that excess mortality arising from depression is a major public health problem that is largely unrecognised and needs to be addressed by a range of clinicians.

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“…7 Recent comprehensive reports show that depression often goes undetected and untreated in cancer patients. 8,9 Despite calls from the National Cancer Institute 10 and the National Comprehensive Cancer Network 11 for systematic detection and treatment of depression in cancer patients, and the availability of evidence-based treatments for depression, [12][13][14][15][16] many depressed cancer patients do not receive effective treatment. 17,18 This gap in care is in part due to the lack of a system of care for depression that can be adapted into oncology clinics and other settings caring for patients with chronic medical illnesses.…”

Section: Introductionmentioning

confidence: 99%