Antidepressants in Patients With Advanced Cancer: When They're Warranted and How to Choose Therapy

Cancer patients with depression experience more physical symptoms, pain, and fatigue; have a poorer quality of life; and are more likely to encounter negative thoughts compared with cancer patients who are not depressed. Accurate assessment and treatment of depression can have a positive impact on improving a patient's quality of life. Pharmacotherapy for depression in patients with advanced cancer should be guided by a focus on symptom reduction, irrespective of whether the patient meets the diagnostic criteria for major depression. For effective treatment of a depressive illness, antidepressant medication and cognitive behavioral therapy need to be initiated sooner rather than later to reduce symptom burden and improve quality of life.