Rapid and temporary improvement of depression and anxiety observed following niraparib administration: a case report

Abstract

Background: Cancer patients are disproportionately affected by generalized anxiety and major depression. For many, current treatments for these conditions are ineffective. In this case report, we present a serendipitous case of anxiety and depression improvement following administration of the poly (ADP-ribose) polymerase (PARP) inhibitor niraparib. Case presentation: A 61-year old woman with a 20-year history of mild depression developed recurrent ovarian carcinoma and was placed on niraparib for maintenance chemotherapy. With the original onset of ovarian cancer, she experienced an episode of major depression that was resolved with sertraline. After recurrence of ovarian cancer, she experienced a recurrence of major depression and a new onset of generalized anxiety that failed to completely respond to multiple medications. After beginning niraparib therapy the patient noticed a rapid resolution of the symptoms of her anxiety and depression, an effect that was limited to 10-14 days. Due to bone marrow suppression, the patient was taken off and restarted on niraparib several times. Each discontinuation of niraparib resulted in return of her depression and anxiety, while each recontinuation of niraparib resulted in an improvement in her mood and anxiety. Conclusions: This case demonstrates rapid and temporary improvement of anxiety and depression following niraparib administration. There is ample preclinical data that PARP signaling may play a role in psychiatric illness. A small amount of indirect data from clinical trials also shows that niraparib may have psychiatric benefits. Further research on PARP inhibition and its potential psychoactive effects is sorely needed.

A literature Review of the Effectiveness of Green Environment on Mental Health and Medical Illness

“…Finally, with regards to practicing meditation and mindfulness in GS among cancer patients 14,34,50 , limitations to GS may reduce their safety measures as they develop neutropenia after receiving chemotherapy which could increase infection risk so special precautions and education must be considered in medical diseases 50 .…”

Niraparib-induced pure red cell aplasia

“…6,7 However, most of randomized controlled trials (RCTs) of PARP inhibitors identified clinical benefits rather than adverse events, and only a brief summary of the severe or even fatal adverse events was provided. [8][9][10] In a recently published meta-analysis of 29 randomized control trials of PARP inhibitors hematological toxicity, it was reported that niraparib caused more hematological toxicity than other PARP inhibitors. This may be due to the stronger trapping effect of niraparib.…”

Accepting Immunotherapy After Multiline Treatment Failure: An Exploration of the Anxiety and Depression in Patients with Advanced Cancer Experience

“…Depression and anxiety are common in patients with advanced cancer. 23 , 24 The incidence of anxiety and depression in some young, advanced or individual types of cancer cases even exceeds 50%. 23 Patients with advanced tumors who receive immunotherapy after multiline treatment failure are different from other cancer cases.…”