Pharmacogenetics of escitalopram and mental adaptation to cancer in palliative care: Report of 18 cases
| Autor: | Giulia, Schillani, Maria Anna, Capozzo, Daniel, Era, Maurizio, De Vanna, Luigi, Grassi, Maria Anna, Conte, Tullio, Giraldi |
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| Přispěvatelé: | Schillani, Giulia, Maria Anna, Capozzo, Era, Daniel, Maurizio De, Vanna, Luigi, Grassi, Maria Anna, Conte, Giraldi, Tullio |
| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Antidepressant drugs Mental adaptation to cancer Palliative care Pharmacogenetics Cancer Research Anxiety Citalopram palliative care pharmacogenetics antidepressant drugs mental adaptation to cancer 03 medical and health sciences 0302 clinical medicine 030502 gerontology Neoplasms Adaptation Psychological mental disorders Humans Aged Polymorphism Genetic General Medicine Middle Aged Italy Oncology 030220 oncology & carcinogenesis pharmacogenetic Antidepressive Agents Second-Generation Female antidepressant drug 0305 other medical science Selective Serotonin Reuptake Inhibitors |
| Zdroj: | Tumori Journal. 97:358-361 |
| ISSN: | 2038-2529 0300-8916 |
| DOI: | 10.1177/030089161109700317 |
| Popis: | Aims and background In palliative care, few data are available on the diagnosis and treatment of mood disorders and of difficulties of mental adaptation to cancer for patients in the advanced phases of the disease. SSRI antidepressants are the treatment of choice; the 5-HTTLPR genetic polymorphism of the serotonin transporter (SERT) has been shown in psychiatry to significantly determine the therapeutic response and the incidence of adverse effects. The aim of the present investigation has been therefore to examine the effects of the SSRI antidepressant escitalopram, also considering 5-HTTLPR, on depression, anxiety and mental adaptation to cancer in palliative care. Methods and study design Eighteen consecutive depressed patients with different forms of advanced cancer admitted to the Hospice Ass 6 of S. Vito al Tagliamento (Pordenone, Italy) were genotyped for the “s” and “l” variants of 5-HTTLPR and were treated with escitalopram. Their response after two weeks of treatment was psycho-metrically evaluated. Results Treatment with escitalopram significantly decreased anxiety scores on the Hospital Anxiety and Depression Scale (HADS) (P = 0.006) as well as anxious preoccupation (P = 0.007) and hopelessness-helplessness (P = 0.017) scores on the Mini Mental Adjustment to Cancer (Mini-MAC) scale. When patients were stratified by SERT genotype, HADS anxiety was significantly decreased in patients carrying the “s/s” and “s/l” variants (P = 0.024), whereas those with an “l/l” genotype displayed a significant reduction of Mini-MAC anxious preoccupation (P = 0.018). Conclusions The results of this study indicate that the use of SSRI antidepressants is effective in the palliative care of cancer patients, and their action affects not only depression but also the patients' mental adaptation to the disease. These results encourage further examination of these drugs in a larger cohort of patients. The significant contribution of pharmacogenetics indicates the possibility of personalized treatment with SSRIs in palliative care. |
| Databáze: | OpenAIRE |
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