Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.1590/2237-6089-2015-0003
Trends in Psychiatry and Psychotherapy
Original Article

Drug interactions between antineoplastic and antidepressant agents: analysis of patients seen at an oncology clinic at a general hospital

Interação medicamentosa entre antineoplásicos e antidepressivos: análise de pacientes do ambulatório de oncologia de um hospital geral

Camila de Araújo Reinert; Marcelo Rodrigues Ribas; Paulo Roberto Zimmermann

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Abstract

Objectives: To determine the prevalence of depressive symptoms among oncology patients and identify simultaneous use of antineoplastic and antidepressant agents.Methods: This was a cross-sectional study that interviewed 56 oncology patients using two data collection instruments: a questionnaire covering clinical and sociodemographic data and the Beck Depression Inventory-II (BDI-II), for assessment of depressive symptoms. For data analysis, descriptive statistics were used to determine the prevalence of depressive symptoms and the chi-square test was used to evaluate associations between sociodemographic and clinical variables and depressive symptoms.Results: A 26.7% (15 patients) prevalence of depression was detected. Just eight of these 15 patients (53.3%) were receiving treatment for depression. In the sample as a whole, 13 of the patients interviewed (23.2%) were taking antidepressants and 11 of these 13 patients (19.6%) were taking antidepressive and antineoplastic agents simultaneously. A total of five (8.9% of the sample) contraindicated drug interactions were detected.Conclusions:Depressive symptoms are more prevalent among cancer patients than in the general population, but they are generally under-diagnosed and under-treated. Simultaneous use of antidepressant and antineoplastic agents is common and so, in order to reduce the number of harmful adverse effects, possible drug interactions must be identified before antidepressants are prescribed to cancer patients.

Keywords

Antidepressive agents, antineoplastic agents, drug interactions, depression, neoplasms

Resumo

Objetivos: Verificar a prevalência de sintomas depressivos em pacientes oncológicos e identificar o uso simultâneo de antineoplásicos e antidepressivos.Métodos: Foi realizado um estudo transversal, no qual 56 pacientes oncológicos foram entrevistados. Foram empregados dois instrumentos: um questionário para a coleta de dados clínicos e sociodemográficos e o Inventário de Depressão de Beck - Segunda Edição (BDI-II) para a avaliação de sintomas depressivos. Para a análise dos dados, foram utilizadas medidas descritivas para determinar a prevalência de sintomas depressivos, o teste de qui-quadrado para avaliar associações entre variáveis sociodemográficas e clínicas e sintomas depressivos.Resultados:Foi encontrada uma prevalência de depressão de 26,7% (15 pacientes). Apenas oito desses pacientes (53,3%) estavam recebendo tratamento para depressão. Considerando a amostra como um todo, estavam fazendo uso de antidepressivos 13 pacientes (23,2%); destes, 11 faziam uso simultâneo de antidepressivo e antineoplásico (19,6%). Foram encontradas cinco situações de interações medicamentosas contraindicadas (8,9%).Conclusão:Sintomas depressivos são mais prevalentes em pacientes oncológicos do que na população em geral, mas geralmente são subdiagnosticados e subtratados. O uso simultâneo de antidepressivos e antineoplásicos é frequente. Sendo assim, para reduzir os efeitos adversos prejudiciais, as possíveis interações medicamentosas devem ser identificadas antes que os antidepressivos sejam prescritos para pacientes oncológicos.

Palavras-chave

Antidepressivos, antineoplásicos, interação de medicamentos, depressão, neoplasias

References

Meijer A, Roseman M, Milette K, Coyne JC, Stefanek ME, Ziegelstein RC. Depression screening and patients outcomes in cancer: a systematic review. PLoS One. 2011;6:e27181.

Miguel C, Albuquerque E. Drug interaction in psycho-oncology: antidepressants and antineoplastics. Pharmacology. 2011;88:333-9.

Okamura M, Azikuzi N, Nakano T, Shimizu K, Ito T, Akechi T. Clinical experience of the use of a pharmacological treatment algorithm for major depressive disorder in patients with advanced cancer. Psychooncology. 2008;17:154-60.

Li M, Fitzgerald P, Rodin G. Evidence-based treatment of depression in patients. J Clin Oncol. 2012;30:1187-96.

Rodin G, Lloyd N, Katz M, Green E, Mackay JA, Wong RK. The treatment of depression in cancer patients: a systematic review. Support Care Cancer. 2007;15:123-36.

Yap KYL, Tay WL, Chui WK, Chan A. Clinically relevant drug interactions between anticancer drug and psychotropic agents. Eur J Cancer Care (Engl). 2011;20:6-32.

Bottino SMB, Fráguas R, Gattaz WF. Depressão e câncer. Rev Psiquiatr Clin. 2009;36:109-15.

Henry NL, Stearns V, Flockhart DA, Hayes DF, Riba M. Drug interactions and pharmacogenomics in the treatment for breast cancer and depression. Am J Psychiatry. 2008;165:1251-5.

Schneider S, Moyer A. Depression as a predictor of disease progression and mortality in cancer patients: a meta-analysis. Cancer. 2010;116:3304.

Saylor MS, Smetana RF. Potential for drug-drug interactions in treating cancer-related nausea and distress. J Oncol Pharm Pract. 2011;17:403-8.

Miller AH, Ancoli-Israel S, Bower JE, Capuron L, Irwin MR. Neuroendocrine-immune mechanisms of behavioral comorbidities in patients with cancer. J Clin Oncol. 2008;26:971-82.

Beck AT, Steer RA, Brown GK. Manual for Beck Depression Inventory II. 1996.

Mitchell AJ, Chan M, Bhatti H, Halton M, Grassi L, Johansen C. Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies. Lancet Oncol. 2011;12:160-74.

Pinquart M, Duberstein PR. Depression and cancer mortality: a meta-analysis. Psychol Med. 2010;40:1797-810.

Warmenhoven F, van Rijswijk E, Engels Y, Kan C, Prins J, van Well C. The Beck Depression Inventory (BDI-II) and a single screening question as screening tools for depressive disorder in Dutch advanced cancer patients. Support Care Cancer. 2012;20:319-24.

Hopwood P, Stephens RJ. Depression in patients with lung cancer: prevalence and risk factors derived from quality-of-life data. J Clin Oncol. 2000;18:893-903.

Raison CL, Miller AH. Depression in cancer: new developments regarding diagnosis and treatment. Biol Psychiatry. 2003;54:283-94.

Pollak Y, Yirmiya R. Cytokine-induced changes in mood and behaviour: implications for 'depression due to a general medical condition', immunotherapy and antidepressive treatment. Int J Neuropsychopharmacol. 2002;5:389-99.

Fafouti M, Paparrigopoulos T, Zervas Y, Rabavilas A, Malamos N, Liappas I. Depression, anxiety and general psychopathology in breast cancer patients: a cross-sectional control study. In Vivo. 2010;24:803-10.

Ringdall GI, Ringdal K, Jordhøy MS, Kaasa S. Does social support from family and friends work as a buffer against reactions to stressful life events such as terminal cancer. Palliat Support Care. 2007;5:61-9.

Ashbury FD1, Madlensky L, Raich P, Thompson M, Whitney G. Antidepressant prescribing in community cancer care. Support Care Cancer. 2003;11:278-85.

Pasquini M, Biondi M, Costantini A, Cairoli F, Ferrarese G, Picardi A. Detection and treatment of depressive and anxiety disorders among cancer patients: feasibility and preliminary findings from a liaison service in an oncology division. Depress Anxiety. 2006;23:441-8.

Walker J, Hansen CH, Martin P, Symeonides S, Ramessur R, Murray G. Prevalence, associations, and adequacy of treatment of major depression in patients with cancer: a cross-sectional analysis of routinely collected clinical data. Lancet Psychiatry. 2014;1:343-50.

Passik SD, Dugan W, McDonald MV, Rosenfeld B, Theobald DE, Edgerton S. Oncologists' recognition of depression in their patients with cancer. J Clin Oncol. 1998;4:1594-600.

Vodermaier A, Linden W, Siu C. Screening for emotional distress in cancer patients: a systematic review of assessment instruments. J Natl Cancer Inst. 2009;101:1464-88.

Hopko DR, Bell JL, Armento ME, Robertson SM, Hunt MK, Wolf NJ. The phenomenology and screening of clinical depression in cancer patients. J Psychosoc Oncol. 2008;26:31-51.

Singer S, Das-Munchi J, Brahler E. Prevalence of mental health conditions in cancer patients in acute care - a meta-analysis. Ann Oncol. 2010;21:925-30.

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