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KMID : 0361520100210020051
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Korean Journal of Psychopharmacology
2010 Volume.21 No. 2 p.51 ~ p.61
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Management of Depression in Terminally Ill Cancer Patients
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Kim Seon-Young
Kim Jae-Min
Kim Sung-Wan
Shin Il-Seon
Yoon Jin-Sang
Shim Hyun-Jeong
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Abstract
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Depression is common in terminally ill cancer patients, and the management of depression in these patients is very important because this condition is associated with distress, suicidal ideation, and decreased quality of life. Antidepressants and psychostimulants are frequently used in the pharmacological treatment of depression in terminally ill cancer patients. The effectiveness of several Selective Serotonin Reuptake Inhibitors (SSRIs) for the treatment of depression in this population has been reported; however, such improvement only occurred approximately 2-4 weeks after the medications were initiated. Psychostimulants offer the advantage of rapid action, an especially important consideration given that terminally ill patients have a short life expectancy. Moreover, methylphenidate has been reported as reversing the sedating effect of opioids, decreasing fatigue, and reducing pain. However, the adverse effect of methylphenidate must be considered. Additionally, psychotherapy also seems to improve depression and anxiety. Members of the treatment teams delivering palliative care often experience emotional burnout. Because emotional burnout results in depression and depersonalization, psychological care for the treatment team is crucial. The end-of-life period of patients is very important because it is the time at which individuals review their lives. Management of the depression in these patients will improve their quality of life and contribute to resolving their end-of-life issues.
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KEYWORD
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Terminal cancer, Depression, Antidepressants, Palliative medicine, Hospice
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