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논문KCI 등재

암환자 우울증의 약물중재

Evidence Based Pharmacotherapy for Depression in Patients with Cancer

유은승|함봉진|김정현
대한신경정신의학회 (Korean Neuropsychiatric Association)|2010.01|신경정신의학 (JOURNAL OF THE KOREAN NEUROPSYCHIATRIC ASSOCIATION)|제49권 제1호|pp. 37-49

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참고문헌

키워드

Cancer·Depression·Pharmacological treatment.암·우울증·약물 치료.
주제분류정신과학

초록

Objectives: A significant number of cancer patients experience depressive disorders. Numerous studies have demonstrated that depression in such patients is under-diagnosed and inadequately treated, due to various factors. One of these factors is a lack of an evidence supporting the use of antidepressants in cancer patients. The aim of this systematic review was to establish the evidence for the pharmacological treatment of depression in this population. Methods: We searched Korean domestic and international database using the keywords“cancer”,“depression”, and“pharmacological treatment”, limiting the search to articles published between 1980 and 2008 and grading the reviewed studies’ quality according to Scottish Intercollegiate Guideline Network (SIGN) methodology. Results: Of 283 studies searched, 28 studies were appropriate for review. Conclusion: The evidence for the pharmacological treatment of depression as limited. However, based on available literature, it seems the newer antidepressants are better tolerated and can be continued safely, with satisfactory efficacy, in cancer patients. Further well-designed, long-term follow-up studies should be conducted.

Abstract

Objectives: A significant number of cancer patients experience depressive disorders. Numerous studies have demonstrated that depression in such patients is under-diagnosed and inadequately treated, due to various factors. One of these factors is a lack of an evidence supporting the use of antidepressants in cancer patients. The aim of this systematic review was to establish the evidence for the pharmacological treatment of depression in this population. Methods: We searched Korean domestic and international database using the keywords“cancer”,“depression”, and“pharmacological treatment”, limiting the search to articles published between 1980 and 2008 and grading the reviewed studies’ quality according to Scottish Intercollegiate Guideline Network (SIGN) methodology. Results: Of 283 studies searched, 28 studies were appropriate for review. Conclusion: The evidence for the pharmacological treatment of depression as limited. However, based on available literature, it seems the newer antidepressants are better tolerated and can be continued safely, with satisfactory efficacy, in cancer patients. Further well-designed, long-term follow-up studies should be conducted.

참고문헌 (56)

  1. Alfano CM, "Recovery issues in cancer survivorship: a new challenge for supportive care", Cancer J, 12, pp.432~443 (2006)
  2. Massie MJ, "Prevalence of depression in patients with cancer", J Natl Cancer Inst Monogr, 32, pp.57~71 (2004)
  3. Kornblith AB, "Psychosocial adaptation of cancer survivors in Psycho-oncology", pp.223~254 (1998), Oxford University Press
  4. Raison CL, "Depression in cancer: new developments regarding diagnosis and treatment", Biol Psychiatry, 54, pp.283~294 (2003)
  5. Evans DL, "Treatment of depression in cancer patients is associated with better life adaptation: a pilot study", Psychosom Med, 50, pp.73~76 (1988)
  6. Fisch M, "Treatment of depression in cancer", J Natl Cancer Inst Monogr, 32, pp.105~111 (2004)
  7. Portenoy RK, "Symptom prevalence, characteristic and distress in a cancer population", Qual Life Res, 3, pp.183~189 (1994)
  8. Walsh D, "The symptoms of advanced cancer: relationship to age, gender, and performance status in 1,000 patients", Support Care Cancer, 8, pp.175~179 (2000)
  9. Cohen-Cole SA, "Diagnostic assessment of depression in the medically ill in Psychiatric Care of the Medical Patient", pp.53~70 (1993), Oxford University Press
  10. Wells KB, "Detection of depressive disorder for patients receiving prepaid or fee-for-service care. Results from the Medical Outcomes Study", JAMA, 262, pp.3298~3302 (1989)
  11. Yirmiya R, "Cytokines, “depression due to a general medical condition”, and antidepressant drugs", Adv Exp Med Biol, 461, pp.283~316 (1999)
  12. Ashbury FD, "Antidepressant prescribing in community cancer care", Support Care Cancer, 11, pp.278~285 (2003)
  13. Torta R, "Sertraline effectiveness and safety in depressed oncological patients", Support Care Cancer, 16, pp.83~91 (2008)
  14. 김성완, "암 환자의 우울증", 생물정신의학, 13(2), pp.1~5 (2006), 대한생물정신의학회
  15. Goetz MP, "The impact of cytochrome P450 2D6 metabolism in women receiving adjuvant tamoxifen", Breast Cancer Res Treat, 101, pp.113~121 (2007)
  16. 김성완, "유방암 환자에서 항우울제의 사용", 대한정신약물학회지, 20(2), pp.63~77 (2009), 대한정신약물학회
  17. Sternbach H, "The serotonin syndrome", Am J Psychiatry, 148, pp.705~713 (1991)
  18. Flint AJ, "Choosing appropriate antidepressant therapy in the elderly. A risk-benefit assessment of available agents", Drugs Aging, 13, pp.269~280 (1998)
  19. Razavi D, "The effect of fluoxetine on anxiety and depression symptoms in cancer patients", Acta Psychiatr Scand, 94, pp.205~210 (1996)
  20. Holland JC, "A controlled trial of fluoxetine and desipramine in depressed women with advanced cancer", Psychooncology, 7, pp.291~300 (1998)
  21. Fisch MJ, "Fluoxetine versus placebo in advanced cancer outpatients: a doubleblinded trial of the Hoosier Oncology Group", J Clin Oncol, 21, pp.1937~1943 (2003)
  22. Pezzella G, "Treatment of depression in patients with breast cancer: a comparison between paroxetine and amitriptyline", Breast Cancer Res Treat, 70, pp.1~10 (2001)
  23. Musselman DL, "Paroxetine for the prevention of depression induced by high-dose interferon alfa", N Engl J Med, 344, pp.961~966 (2001)
  24. Weitzner MA, "A pilot trial of paroxetine for the treatment of hot flashes and associated symptoms in women with breast cancer", J Pain Symptom Manage, 23, pp.337~345 (2002)
  25. Morrow GR, "Differential effects of paroxetine on fatigue and depression: a randomized double-blind trial from the University of Rochester Cancer Centre Community Clinical Oncology Program", J Clin Oncol, 21, pp.4635~4641 (2003)
  26. Pae CU, "Paroxetine in the treatment of depressed patients with haematological malignancy", Hum Psychopharmacol, 19, pp.25~29 (2004)
  27. Roscoe JA, "Effect of paroxetine hydrochloride (Paxil) on fatigue and depression in breast cancer patients receiving chemotherapy", Breast Cancer Res Treat, 89, pp.243~249 (2005)
  28. Musselman DL, "A double-blind, multicenter, parallel-group study of paroxetine, desipramine, or placebo in breast cancer patients (stages I, II, III, and IV) with major depression", J Clin Psychiatry, 67, pp.288~296 (2006)
  29. Preskorn SH, "Clinically relevant pharmacology of selective serotonin reuptake inhibitors. An overview with emphasis on pharmacokinetics and effects on oxidative drug metabolism", Clin Pharmacokinet, 32(suppl 1), pp.1~21 (1997)
  30. Plouffe L Jr, "An open trial of sertraline for menopausal hot flashes: potential involvement of serotonin in vasomotor instability", Del Med J, 69, pp.481~482 (1997)
  31. Roth AJ, "Sertraline relieves hot flashes secondary to medical castration as treatment of advanced prostate cancer", Psychooncology, 7, pp.129~132 (1998)
  32. Stockler MR, "Effect of sertraline on symptoms and survival in patients with advanced cancer, but without major depression: a placebo-controlled double-blind randomised trial", Lancet Oncol, 8, pp.603~612 (2007)
  33. Watson M, "Coping with cancer: the Mini-Mac. ICPO. Beaune", ~
  34. Theobald DE, "An open label pilot study of citalopram for depression and boredom in ambulatory cancer patients", Palliat Support Care, 1, pp.71~77 (2003)
  35. Lydiatt WM, "A randomized, placebo-controlled trial of citalopram for the prevention of major depression during treatment for head and neck cancer", Arch Otolaryngol Head Neck Surg, 134, pp.528~535 (2008)
  36. Feighner JP, "The role of venlafaxine in rational adntidepressant therapy", J Clin Psychiatry, 55(suppl A), pp.62~68 (1994)
  37. Miller K, "Depression and anxiety", Cancer J, 12, pp.388~397 (2006)
  38. Moss EL, "An open-label study of the effects of bupropion SR on fatigue, depression and quality of life of mixed-site cancer patients and their partners", Psychooncology, 15, pp.259~267 (2006)
  39. Cullum JL, "Bupropion sustained release treatment reduces fatigue in cancer patients", Can J Psychiatry, 49, pp.139~144 (2004)
  40. Stahl SM, "Essential psychopharmacology of depression and bipolar disorder" (2000), Cambridge University Press
  41. Ersoy MA, "An open-label long-term naturalistic study of mirtazapine treatment for depression in cancer patients", Clin Drug Investig, 28, pp.113~120 (2008)
  42. Kim SW, "Effectiveness of mirtazapine for nausea and insomnia in cancer patients with depression", Psychiatry Clin Neurosci, 62, pp.75~83 (2008)
  43. Thompson DS, "Mirtazapine for the treatment of depression and nausea in breast and gynecological oncology", Psychosomatics, 41, pp.356~359 (2000)
  44. Theobald DE, "An open-label, crossover trial of mirtazapine (15 and 30 mg) in cancer patients with pain and other distressing symptoms", J Pain Symptom Manage, 23, pp.442~447 (2002)
  45. Costa D, "Efficacy and safety of mianserin in the treatment of depression of women with cancer", Acta Psychiatr Scand Suppl, 320, pp.85~92 (1985)
  46. van Heeringen K, "Pharmacological treatment of depression in cancer patients. A placebo-controlled study of mianserin", Br J Psychiatry, 169, pp.440~443 (1996)
  47. Holland JC, "A randomized clinical trial of alprazolam versus progressive muscule relaxation in cancer patients with anxiety and depessive symptoms", J Clin Oncol, 9, pp.1004~1011 (1991)
  48. Rodin G, "Supportive care guideline group of cancer care ontario program in evidence-based care. The treatment of depression in cancer patients: a systematic review", Support Care Cancer, 15, pp.123~136 (2007)
  49. Walsh D, "Symptom control in advanced cancer: important drugs and routes of administration", Semin Oncol, 27, pp.69~83 (2000)
  50. Satel SL, "Stimulants in the treatment of depression: a critical overview", J Clin Psychiatry, 50, pp.241~249 (1989)
  51. Fernandez F, "Methylphenidate for depressive disorders in cancer patients. An alternative to standard antidepressants", Psychosomatics, 28, pp.455~461 (1987)
  52. Olin J, "Psychostimulants for depression in hospitalized cancer patients", Psychosomatics, 37, pp.57~62 (1996)
  53. Macleod AD, "Methylphenidate in terminal depression", J Pain Symptom Manage, 16, pp.193~198 (1998)
  54. Homsi J, "Methylphenidate for depression in hospice practice: a case series", Am J Hosp Palliat Care, 17, pp.393~398 (2000)
  55. Homsi J, "A phase II study of methylphenidate for depression in advanced cancer", Am J Hosp Palliat Care, 18, pp.403~407 (2001)
  56. Goodnick PJ, "Pharmacokinetic optimisation of therapy with newer antidepressants", Clin Pharmacokinet, 27, pp.307~330 (1994)

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