SUMMARY
Depression is common in patients with advanced, irreversible disease, but it is not normal. Many drugs and morbid states have been associated with depression. Psychotherapy, cognitive therapy, and electroconvulsive therapy, as well as pharmacotherapy may be helpful. The use of antidepressants and psychostimulants to manage depression in terminally ill patients is reviewed. Evaluation instruments that have been used to assess depression in this population are described. Some open research questions are listed. A treatment algorithm, evidence tables, and drug therapy tables which include drug costs are presented.
KEYWORDS:
- Depression
- agitation
- insomnia
- affect
- mood
- energy
- apathy
- anger
- withdrawal
- noncompliance
- palliative care
- terminal care
- dying
- supportive care
- non-pharmacological therapy
- drug therapy
- etiology
- evidence
- costs
- algorithm
- inhibitors
- psychotherapy
- education
- electroconvulsive therapy (ECT)
- psychostimulants
- dextroamphetamine
- methylphenidate
- pemoline
- tricyclic antidepressants (TCA)
- amitripty-line
- desipramine
- norptriptyline
- doxepin
- diazepam
- bupropion
- selective serotonin reuptake inhibitors
- SSRI
- fluoxetine
- fluvoxamine
- parox-etine
- sertraline
- citalopram
- mirtazapine
- venlafaxine
- thrioridazine
- trazodone
- nefazodone
- amoxapine
- monoamine oxidase inhibitors (MAOI)
- phenelzine
- tranylcypromine