Clinical experience of the use of a pharmacological treatment algorithm for major depressive disorder in patients with advanced cancer

被引:22
作者
Okamura, Masako [2 ]
Akizuki, Nobuya [1 ]
Nakano, Tomohito [2 ]
Shimizu, Ken [2 ]
Ito, Tatsuhiko [1 ]
Akechi, Tatsuo [3 ]
Uchitomi, Yosuke [1 ]
机构
[1] Natl Canc Ctr Hosp E, Psychooncol Div, Res Ctr Innovat Oncol, Kashiwa, Chiba 2778577, Japan
[2] Natl Canc Ctr, Div Psychiat, Chuo Ku, Tokyo 1040045, Japan
[3] Nagoya City Univ, Sch Med, Dept Psychiat, Mizuho Ku, Nagoya, Aichi 4678601, Japan
关键词
algorithm; major depressive disorder; advanced cancer; antidepressant; clinical experience;
D O I
10.1002/pon.1213
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The objective of this study was to describe the applicability and the dropout of the pharmacological treatment algorithm for major depressive disorder in patients with advanced cancer. Psychiatrists treated major depressive disorder in advanced cancer patients on the basis of the algorithm. For discussing the problems related to the algorithm, we reviewed the reasons for the non-application of the algorithm and the reasons for dropout of patients within a week of initiation of treatment. The algorithm was applied in 54 of 59 cases (applicability rate, 92%). The reasons for the non-application of the algorithm were as follows: the need to add a benzodiazepine to an antidepressant in 4 cases and the need to choose alprazolam despite the depression being moderate in severity, in order to obtain a rapid onset action and reduce anxiety in a patient with short prognosis. Nineteen of the 55 patients dropped out within a week of initiation of treatment based on the algorithm. Delirium was the most frequent reason for dropout. The applicability rate was high, but several problems were identified, including those related to the combination of antidepressants and benzodiazepines, pharmacological treatment of depression in patients with short prognosis, and delirium due to antidepressants. Copyright (C) 2007 John Wiley & Sons, Ltd.
引用
收藏
页码:154 / 160
页数:7
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