The choice of antidepressant depends on a patient's medical history and concomitant medical problems, the symptoms referable to depression, previous responses to antidepressant medications, and the side effects associated with the agents available.
The types of medications used to treat depression in patients with cancer include:
- Tricyclic antidepressants (TCAs)
: amitriptyline, clomipramine, desipramine, doxepin, imipramine, nortriptyline
- Selective serotonin reuptake inhibitors (SSRIs)
: citalopram, fluoxetine, escitalopram, fluvoxamine, paroxetine, sertraline
- Monoamine oxidase inhibitors (MAOIs)
: tranylcypromine, phenelzin, selegiline
- Atypical antidepressants
: bupropion, trazodone, nefazodone, mirtazapine, venlafaxine, duloxetine
: dextroamphetamine, methylphenidate, dexmethylphenidate
When selecting antidepressants, either singly or in combination
- Target specific distressing symptoms.
- Evaluate coexistent medical problems that may be exacerbated by particular antidepressants.
- Minimize side effects and avoid worsening of current health status.
- Determine the patient's ability to swallow solid dosage forms; they may be able to take an antidepressant in liquid form. Alternatively, some antidepressants are available as parenteral dosage forms.
- Evaluate the patient's medication profile for potential interactions with antidepressant drugs.
For drug-specific dosages, side effects and comments, see reference.
National Cancer Institute. Depression. Accessed August 20, 2009.