Should I Change Antidepressant Medication During Cancer Treatment
It’s common for patients already taking antidepressants to experience worsening or new symptoms of depression or anxiety when diagnosed with and undergoing treatment for cancer.
New or worsening symptoms may be due to a combination of factors, including:
- Psychological impact of the diagnosis: Shock, fear, uncertainty, and grief are natural responses to a cancer diagnosis and can intensify pre-existing mental health conditions.
- Physical effects of cancer and treatment: Cancer itself and treatments like chemotherapy, immunotherapy, and hormone therapy can cause fatigue, pain, nausea, and other physical symptoms that can contribute to depression and anxiety.
- Medication side effects and interactions: Some cancer treatments or medications can interact with antidepressants, potentially affecting their effectiveness or causing unexpected side effects. For example, some antidepressants can interfere with the metabolism of certain chemotherapy drugs, like tamoxifen, anastrozole, etc.
- Social and environmental factors: Cancer can disrupt a patient’s social support systems, finances, and daily routines, further increasing vulnerability to depression and anxiety.
Patients on antidepressants being treated for cancer may need adjustments to their medication. This may involve:
- Increased dosage: If the existing dose of antidepressant is no longer effectively managing depressive symptoms, an increase might be necessary.
- Switching antidepressants: Due to potential drug interactions or the emergence of new symptoms, changing to a different antidepressant might be considered.
- Adding other medications: Antianxiety medications might be added to manage anxiety, or other medications might be used to address specific symptoms like insomnia or neuropathic pain.
- Any changes to psychotropic medications should be made only after consulting with the prescribing physician.
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Important considerations:
- Close collaboration among the oncology team, mental health professionals (LCSW-Licensed Clinical Social Worker, psychiatrist, psychologist), and the patient is crucial to optimize care and ensure safe and effective medication management.
- Antidepressant dosages and treatment plans need to be tailored to each patient’s individual needs, considering factors like the type of cancer and treatment, existing mental health conditions, and potential drug interactions.
- Regular monitoring is essential to ensure the safety and effectiveness of the antidepressant and to identify and manage any potential interactions with cancer treatments.
- Addressing mental health needs is a vital part of comprehensive cancer care and can improve overall well-being and treatment outcomes.
It’s common for patients on antidepressants to need their medication adjusted or changed when undergoing cancer treatment due to the complex interplay of factors affecting their physical and mental well-being. Consider consulting with the prescribing physician to review current medications; referral to a behavioral health therapist may be appropriate. Florida Cancer Specialists & Research Institute offers access to a team of licensed clinical social workers who provide telehealth therapy services for FCS patients in need of additional emotional or psychological support.
References:
- Journal of Clinical Oncology; “Management of Anxiety and Depression in Adult Survivors of Cancer: ASCO Guideline Update,” 4/19/23
- NIH National Library of Medicine; “Antidepressants for the treatment of depression in people with cancer;” Revised 3/23
- Science Direct; “The use of antidepressants in oncology: a review and practical tips for oncologists;” Annals of Oncology, Vol. 29, Issue 1, 11/18
about the author
Leah Sandridge, MSW, LCSW
Leah is a Licensed Clinical Social Worker and has been providing mental health therapy for more than 25 years. She has extensive experience working with patients dealing with a wide range of issues, including depression, anxiety, trauma, PTSD, chronic pain and chronic health issues, end of life issues, adjustment challenges, substance abuse, physical, sexual and emotional abuse, ADHD and other learning disabilities including Autism Spectrum Disorder, marital and family issues.
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