Mood and Anxiety in Cancer Pain

  • R. Garrett KeyEmail author
  • William S. Breitbart


Mood and anxiety disorders are found at increased rates in cancer patients, particularly in the context of pain. These disorders can complicate pain treatment and should be addressed to maximize pain control, functional status, and overall quality of life in patients living with cancer-related pain. A variety of tools for the treatment of anxiety and depression exist and are an essential part of comprehensive pain management. A solely physiological approach is likely to incompletely address a cancer patient’s pain needs. We recommend a comprehensive approach based on a biopsychosocial model of pain that includes treatment of associated anxiety and depression in addition to standard somatic therapies. A multimodal approach that involves a patient’s family in treatment planning and addresses the psychosocial needs of the patient is most effective and supported by the American Pain Society and the Institute of Medicine (Gordon et al. Arch Intern Med165(14):1574–80, 2005; Miaskowski et al. Guideline for the management of cancer pain in adults and children. American Pain Society, Glenview, 2005; Institute of Medicine. Committee on Advancing Pain Research C, Education. Relieving pain in America: a blueprint for transforming prevention, care, education, and research. National Academies Press, Washington, DC, 2011).


Cancer Pain Psycho-oncology Anxiety Depression 


  1. 1.
    Gordon DB, Dahl JL, Miaskowski C, McCarberg B, Todd KH, Paice JA, et al. American pain society recommendations for improving the quality of acute and cancer pain management: American pain society quality of care task force. Arch Intern Med. 2005;165(14):1574–80.PubMedCrossRefGoogle Scholar
  2. 2.
    Miaskowski C, Cleary J, Burney R, Coyne P, Finley R, Foster R, et al. Guideline for the management of cancer pain in adults and children. Glenview: American Pain Society; 2005.Google Scholar
  3. 3.
    Institute of Medicine. Committee on Advancing Pain Research C, Education. Relieving pain in America: a blueprint for transforming prevention, care, education, and research. Washington, DC: National Academies Press; 2011.Google Scholar
  4. 4.
    Foley KM. The treatment of cancer pain. N Engl J Med. 1985, 313:845.PubMedCrossRefGoogle Scholar
  5. 5.
    Weiss SC, Emanuel LL, Fairclough DL, Emanuel EJ. Understanding the experience of pain in terminally ill patients. Lancet. 2001;357:1311–5.PubMedCrossRefGoogle Scholar
  6. 6.
    Fitzgibbon DR. Cancer pain: management. In: Loeser JD, editor. Bonica’s management of pain. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2001. p. 659–703.Google Scholar
  7. 7.
    Twycross RG, Lack SA. Symptom control in far advanced cancer: pain relief. London: Pitman Brooks; 1983.Google Scholar
  8. 8.
    Grond S, Zech D, Diefenbach C, Bischoff A. Prevalence and pattern of symptoms in patients with cancer pain: a prospective evaluation of 1635 cancer patients referred to a pain clinic. J Pain Symptom Manag. 1994;9:372–82.CrossRefGoogle Scholar
  9. 9.
    Walsh D, Donnelly S, Rybicki L. The symptoms of advanced cancer: relationship to age, gender, and performance status in 1000 patients. Support Care Cancer. 2000;8(3):175–9.PubMedCrossRefGoogle Scholar
  10. 10.
    Achte KA, Vanhkouen ML. Cancer and the psych. Omega. 1971;2:46–56.Google Scholar
  11. 11.
    Syrjala KL, Chapko ME. Evidence for a biopsychosocial model of cancer treatment-related pain. Pain. 1995;61:69–79.PubMedCrossRefPubMedCentralGoogle Scholar
  12. 12.
    Gatchel RJ, Peng YB, Peters ML, Fuchs PN, Turk DC. The biopsychosocial approach to chronic pain: scientific advances and future directions. Psychol Bull. 2007;133(4):581.PubMedCrossRefPubMedCentralGoogle Scholar
  13. 13.
    Turk DC, Okifuji A. Psychological factors in chronic pain: evolution and revolution. J Consult Clin Psychol. 2002;70(3):678.PubMedCrossRefPubMedCentralGoogle Scholar
  14. 14.
    Melzack R, Wall PD. Pain mechanisms: a new theory. Science. 1965;150(3699):971–9.CrossRefGoogle Scholar
  15. 15.
    Foley KM. Pain syndromes in patients with cancer. In: Bonica JJ, VV RBF, Jones LE, Loeser JD, editors. Advances in pain research and therapy, vol. 2. New York: Raven Press; 1975. p. 59–75.Google Scholar
  16. 16.
    Breitbart W, Holland J. Psychiatric aspects of cancer pain. In: Foley KM, editor. Advances in pain research and therapy, vol. 16. New York: Raven Press; 1990. p. 73–87.Google Scholar
  17. 17.
    Breitbart W. Psychiatric management of cancer pain. Cancer. 1989;63:2336–42.PubMedCrossRefPubMedCentralGoogle Scholar
  18. 18.
    Massie MJ, Holland JC. The cancer patient with pain: psychiatric complications and their mangement. Med Clin N Am. 1987;71:243–58.PubMedCrossRefPubMedCentralGoogle Scholar
  19. 19.
    Stiefel F. Psychosocial aspects of cancer pain. Support Care Cancer. 1993;1:130–4.PubMedCrossRefPubMedCentralGoogle Scholar
  20. 20.
    Saunders CM. The management of terminal illness. London: Hospital Medicine Publications; 1967.Google Scholar
  21. 21.
    Sheinfeld Gorin S, Krebs P, Badr H, Janke EA, Jim HS, Spring B, et al. Meta-analysis of psychosocial interventions to reduce pain in patients with cancer. J Clin Oncol. 2012;30(5):539–47.PubMedCrossRefPubMedCentralGoogle Scholar
  22. 22.
    McWilliams LA, Cox BJ, Enns MW. Mood and anxiety disorders associated with chronic pain: an examination in a nationally representative sample. Pain. 2003;106(1):127–33.PubMedCrossRefPubMedCentralGoogle Scholar
  23. 23.
    Akechi T, Okuyama T, Sugawara Y, Nakano T, Shima Y, Uchitomi Y. Major depression, adjustment disorders, and post-traumatic stress disorder in terminally ill cancer patients: associated and predictive factors. J Clin Oncol. 2004;22(10):1957–65.PubMedCrossRefPubMedCentralGoogle Scholar
  24. 24.
    Daut RL, Cleeland CS. The prevalence and severity of pain in cancer. Cancer. 1982;50:1913–8.PubMedCrossRefPubMedCentralGoogle Scholar
  25. 25.
    McKegney FP, Bailey CR, Yates JW. Prediction and management of pain in patients with advanced cancer. Gen Hosp Psychiatry. 1981;3:95–101.PubMedCrossRefPubMedCentralGoogle Scholar
  26. 26.
    Bond MR, Pearson IB. Psychological aspects of pain in women with advanced cancer of the cervix. J Psychosom Res. 1969;13:13–9.PubMedCrossRefPubMedCentralGoogle Scholar
  27. 27.
    Spiegel D, Bloom JR. Pain in metastatic breast cancer. Cancer. 1983;52:341–5.PubMedCrossRefPubMedCentralGoogle Scholar
  28. 28.
    Smith WB, Gracely RH, Safer MA. The meaning of pain: cancer patients’ rating and recall of pain intensity and affect. Pain. 1998;78(2):123–9.PubMedCrossRefPubMedCentralGoogle Scholar
  29. 29.
    Padilla G, Ferrell B, Grant M, Rhiner M. Defining the content domain of quality of life for cancer patients with pain. Cancer Nurs. 1990;13:108–15.PubMedCrossRefPubMedCentralGoogle Scholar
  30. 30.
    Strang P. Existential consequences of unrelieved cancer pain. Palliat Med. 1997;11(4):299–305.PubMedCrossRefGoogle Scholar
  31. 31.
    Payne D. Cognition in cancer pain. Unpublished dissertation 1995.Google Scholar
  32. 32.
    Portenoy RK, Payne D, Jacobsen P. Breakthrough pain: characteristics and impact in patients with cancer pain. Pain. 1999;81(1–2):129–34.PubMedCrossRefGoogle Scholar
  33. 33.
    Grossman SA, Sheidler VR, Sweden K, Mucenski J, Piantadosi S. Correlations of patient and caregiver ratings of cancer pain. J Pain Symptom Manag. 1991;6(2):53–7.CrossRefGoogle Scholar
  34. 34.
    Marks RM, Sachar EJ. Undertreatment of medical inpatients with narcotic analgesics. Ann Intern Med. 1973;78:173–81.PubMedCrossRefGoogle Scholar
  35. 35.
    Cleeland CS, Tearnan BH. Behavioral control of cancer pain. In: Holzman AD, Turk DC, editors. Pain Mangement. New York: Pergamon Press; 1986. p. 93–212.Google Scholar
  36. 36.
    Derogatis LR, Morrow GR, Fetting J, Penman D, Piasetsky S, Schmale AM, Henrichs M, Carnicke CL Jr. The prevalence of psychiatric disorders among cancer patients. J Am Med Assoc. 1983;249:751–7.CrossRefGoogle Scholar
  37. 37.
    Ahles TA, Blanchard EB, Ruckdeschel JC. The multi-dimensional nature of cancer related pain. Pain. 1983;17:277–88.PubMedCrossRefGoogle Scholar
  38. 38.
    Woodforde JM, Fielding JR. Pain and cancer. J Psychosom Res. 1970;14:365–70.PubMedCrossRefGoogle Scholar
  39. 39.
    Mitchell AJ, Chan M, Bhatti H, Halton M, Grassi L, Johansen C, et al. Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies. Lancet Oncol. 2011;12(2):160–74.PubMedCrossRefGoogle Scholar
  40. 40.
    Massie MJ. Prevalence of depression in patients with cancer. J Natl Cancer Inst Monogr. 2004;2004(32):57–71.CrossRefGoogle Scholar
  41. 41.
    Filiberti A, Ripamonti C, Totis A, Ventafridda V, De Conno F, Contiero P, et al. Characteristics of terminal cancer patients who committed suicide during a home palliative care program. J Pain Symptom Manag. 2001;22(1):544–53.CrossRefGoogle Scholar
  42. 42.
    Levin DN, Cleeland CS, Dan R. Public attitudes toward cancer pain. Cancer. 1985;56:2337–9.PubMedCrossRefGoogle Scholar
  43. 43.
    Farberow NL, Schneidman ES, Leonard CV. Suicide among general medical and surgical hospital patients with malignant neoplasms. Washington, DC: US Veterans Administration; 1963. Contract No: Medical Bulletin 9.Google Scholar
  44. 44.
    Breitbart W. Suicide in cancer patients. Oncology. 1987;1:49–53.PubMedGoogle Scholar
  45. 45.
    Breitbart W. Cancer pain and suicide. In: Foley KM, editor. Advances in pain research and therapy, vol. 16. New York: Raven Press; 1990. p. 399–412.Google Scholar
  46. 46.
    Bolund C. Suicide and cancer: II. Medical and care factors in suicide by cancer patients in Sweden, 1973–1976. J Psychosoc Oncol. 1985;3:17–30.CrossRefGoogle Scholar
  47. 47.
    Silberfarb PM, Manrer LH, Cronthamel CS. Psychological aspects of neoplastic disease, I: functional status of breast cancer patients during different treatment regimens. Am J Psychiatr. 1980;137:450–5.PubMedCrossRefGoogle Scholar
  48. 48.
    Brown JH, Henteleff P, Barakat S, Rowe JR. Is it normal for terminally ill patients to desire death. Am J Psychiatr. 1986;143:208–11.PubMedCrossRefGoogle Scholar
  49. 49.
    Breitbart W, Rosenfeld B, Pessin H, Kaim M, Funesti-Esch J, Galietta M, Nelson CJ, Brescia R. Depression, hopelessness, and desire for hastened death in terminally ill patients with cancer. J Am Med Assoc. 2000;284(22):2907–11.CrossRefGoogle Scholar
  50. 50.
    Endicott J. Measurement of depression in patients with cancer. Cancer. 1984;53(10 Suppl):2243–9.PubMedCrossRefGoogle Scholar
  51. 51.
    Spitzer RL, Kroenke K, Williams JB. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary care evaluation of mental disorders. Patient health questionnaire. JAMA. 1999;282(18):1737–44.PubMedCrossRefGoogle Scholar
  52. 52.
    Spitzer RL, Kroenke K, Williams JB, Lowe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092–7.PubMedCrossRefGoogle Scholar
  53. 53.
    Bukberg J, Penman D, Holland J. Depression in hospitalized cancer patients. Psychosom Med. 1984;43:199–212.CrossRefGoogle Scholar
  54. 54.
    Massie JM, Holland JC, Glass E. Delirium in terminally ill cancer patients. Am J Psychiatr. 1983;140:1048–50.PubMedCrossRefGoogle Scholar
  55. 55.
    Katz N, Mazer NA. The impact of opioids on the endocrine system. Clin J Pain. 2009;25(2):170–5.PubMedCrossRefGoogle Scholar
  56. 56.
    Daniell HW, Lentz R, Mazer NA. Open-label pilot study of testosterone patch therapy in men with opioid-induced androgen deficiency. J Pain. 2006;7(3):200–10.PubMedCrossRefGoogle Scholar
  57. 57.
    Smoller JW, Pollack MH, Otto MW, Rosenbaum JF, Kradin RL. Panic anxiety, dyspnea, and respiratory disease. Theoretical and clinical considerations. Am J Respir Crit Care Med. 1996;154(1):6–17.PubMedCrossRefGoogle Scholar
  58. 58.
    Dickerman AL, Barnhill JW. Abnormal thyroid function tests in psychiatric patients: a red herring? Am J Psychiatry. 2012;169(2):127–33.PubMedCrossRefGoogle Scholar
  59. 59.
    Isenberg-Grzeda E, Kutner HE, Nicolson SE. Wernicke-Korsakoff-syndrome: under-recognized and under-treated. Psychosomatics. 2012;53(6):507–16.PubMedCrossRefGoogle Scholar
  60. 60.
    Benton D, Griffiths R, Haller J. Thiamine supplementation mood and cognitive functioning. Psychopharmacology. 1997;129(1):66–71.PubMedCrossRefGoogle Scholar
  61. 61.
    Gloth FM 3rd, Alam W, Hollis B. Vitamin D vs broad spectrum phototherapy in the treatment of seasonal affective disorder. J Nutr Health Aging. 1999;3(1):5–7.PubMedGoogle Scholar
  62. 62.
    Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357(3):266–81.PubMedCrossRefGoogle Scholar
  63. 63.
    Jorde R, Sneve M, Figenschau Y, Svartberg J, Waterloo K. Effects of vitamin D supplementation on symptoms of depression in overweight and obese subjects: randomized double blind trial. J Intern Med. 2008;264(6):599–609.PubMedCrossRefGoogle Scholar
  64. 64.
    Tiemeier H, van Tuijl HR, Hofman A, Meijer J, Kiliaan AJ, Breteler MM. Vitamin B12, folate, and homocysteine in depression: the Rotterdam study. Am J Psychiatry. 2002;159(12):2099–101.PubMedCrossRefGoogle Scholar
  65. 65.
    Miller AH, Maletic V, Raison CL. Inflammation and its discontents: the role of cytokines in the pathophysiology of major depression. Biol Psychiatry. 2009;65(9):732–41.PubMedPubMedCentralCrossRefGoogle Scholar
  66. 66.
    Dantzer R, O’Connor JC, Freund GG, Johnson RW, Kelley KW. From inflammation to sickness and depression: when the immune system subjugates the brain. Nat Rev Neurosci. 2008;9(1):46–56.PubMedPubMedCentralCrossRefGoogle Scholar
  67. 67.
    Asnis GM, De La Garza R 2nd, Kohn S, Reinus J, Henderson M, Shah J. IFN-induced depression: a role for NSAIDs. Psychopharmacol Bull. 2002;37(3):29–50.Google Scholar
  68. 68.
    Breitbart W. Psychotropic adjuvant analgesics for cancer pain. Psycho-Oncology. 1992;1:133–45.CrossRefGoogle Scholar
  69. 69.
    France RD. The future for antidepressants: treatment of pain. Psychopathology. 1987;20:99–113.PubMedCrossRefGoogle Scholar
  70. 70.
    Getto CJ, Sorkness CA, Howell T. Antidepressants and chronic nonmalignant pain: a review. J Pain Symptom Control. 1987;2:9–18.CrossRefGoogle Scholar
  71. 71.
    Walsh TD. Antidepressants and chronic pain. Clin Neuropharmacol. 1983;6:271–95.PubMedCrossRefGoogle Scholar
  72. 72.
    Walsh TD, editor. Adjuvant analgesic therapy in cancer pain. Second international congress on cancer pain. New York: Raven Press; 1990.Google Scholar
  73. 73.
    Butler S. Present status of tricyclic antidepressants in chronic pain therapy. In: Benedetti C, Chapman CR, Moricca G, editors. Advances in pain research and therapy, vol. 7. New York: Raven Press; 1986. p. 173–96.Google Scholar
  74. 74.
    Ventafridda V, Bonezzi C, Caraceni A, DeConno F, Guarise G, Ramella G, Saita L, Silvani V, Tamburini M, Toscani F. Antidepressants for cancer pain and other painful syndromes with deafferentation component: comparison of amitriptyline and trazodone. Ital J Neurol Sci. 1987;8:579–87.PubMedCrossRefGoogle Scholar
  75. 75.
    Magni G, Arsie D, DeLeo D. Antidepressants in the treatment of cancer pain. A survey in Italy. Pain. 1987;29:347–53.PubMedCrossRefGoogle Scholar
  76. 76.
    Onghena P, Van Houdenhove B. Antidepressant-induced analgesia in chronic non-malignant pain: a meta-analysis of 39 placebo-controlled studies. Pain. 1992;49:205–19.PubMedCrossRefGoogle Scholar
  77. 77.
    McQuay H, Tramer M, Nye B, Carroll D, Wiffen P, Moore R. A systematic review of antidepressants in neuropathic pain. Pain. 1996;68(2):217–27.PubMedCrossRefGoogle Scholar
  78. 78.
    Farrar JT, Portenoy RK. Neuropathic cancer pain: the role of adjuvant analgesics. Oncology. 2001;15(11):1435–42, 45, 50–3.Google Scholar
  79. 79.
    Max MB, Culnane M, Schafer SC, Gracely RH, Walther DJ, Smoller B, Dubner R. Amitriptyline relieves diabetic-neuropathy pain in patients with normal and depressed mood. Neurology. 1987;37:589–96.PubMedCrossRefGoogle Scholar
  80. 80.
    Max MB, Schafer SC, Culnane M, Smollen B, Dubner R, Gracel RH. Amitriptyline, but not lorazepam, relieves postherpetic neuralgia. Neurology. 1982;38:427–32.Google Scholar
  81. 81.
    Pilowsky I, Hallett EC, Bassett DL, Thomas PG, Penhall RK. A controlled study of amitriptyline in the treatment of chronic pain. Pain. 1982;14:169–79.PubMedCrossRefGoogle Scholar
  82. 82.
    Sharav Y, Singer E, Schmidt E, Dione RA, Dubner R. The analgesic effect of amitriptyline on chronic facial pain. Pain. 1987;31:199–209.PubMedCrossRefGoogle Scholar
  83. 83.
    Watson CP, Evans RJ, Reed K, Merskey H, Goldsmith L, Warsh J. Amitriptyline versus placebo in post herpetic neuralgia. Neurology. 1982;32:671–3.PubMedCrossRefGoogle Scholar
  84. 84.
    Kvindesal B, Molin J, Froland A, Gram LF. Imipramine treatment of painful diabetic neuropathy. J Am Med Assoc. 1984;251:1727–30.CrossRefGoogle Scholar
  85. 85.
    Young RJ, Clarke BF. Pain relief in diabetic neuropathy: the effectiveness of imipramine and related drugs. Diabet Med. 1985;2:363–6.PubMedCrossRefGoogle Scholar
  86. 86.
    Sindrup SH, Ejlertsen B, Frøland A, Sindrup EH, Brøsen K, Gram LF. Imipramine treatment in diabetic neuropathy: relief of subjective symptoms without changes in peripheral and autonomic nerve function. Eur J Clin Pharmacol. 1989;37:151–3.PubMedCrossRefGoogle Scholar
  87. 87.
    Max MB, Kishore-Kumar R, Schafer SC, Meister B, Gracely RH, Smoller B, Dubner R. Efficacy of desipramine in painful diabetic neuropathy: a placebo-controlled trial. Pain. 1991;45:3–10.PubMedCrossRefGoogle Scholar
  88. 88.
    Gordon N, Heller P, Gear R, Levine J. Temporal factors in the enhancement of morphine analgesic by desipramine. Pain. 1993;53:273–6.PubMedCrossRefGoogle Scholar
  89. 89.
    Gomez-Perez FJ, Rull JA, Dies H, Rodriquez-Rivera JG, Gonzalez-Barranco J, Lozano-Castañeda O. Nortriptyline and fluphenazine in the symptomatic treatment of diabetic neuropathy. A double-blind cross-over study. Pain. 1985;23:395–400.PubMedCrossRefGoogle Scholar
  90. 90.
    Langohr HD, Stohr M, Petruch F. An open and double-blind crosover study on the efficacy of clomipramine (anafranil) in patients with painful mono- and polyneuropathies. Eur Neurol. 1982;21:309–15.PubMedCrossRefPubMedCentralGoogle Scholar
  91. 91.
    Tiegno M, Pagnoni B, Calmi A, Rigoli M, Braga PC, Panerai AE. Chlorimipramine compared to pentazocine as a unique treatment in post-operative pain. Int J Clin Pharmacol Res. 1987;7:141–3.Google Scholar
  92. 92.
    Hameroff SR, Cork RC, Scherer K, Crago BR, Neuman C, Womble JR, Davis TP. Doxepin effects on chronic pain, depression and plasma opioids. J Clin Psychiatry. 1982;2:22–6.Google Scholar
  93. 93.
    Walsh TD, editor. Controlled study of imipramine and morphine in chronic pain due to advanced cancer (Abstract). Los Angeles: ASCO; 1986.Google Scholar
  94. 94.
    Watson C, Chipan M, Reed K, Evans R, Birket N. Amitriptyline versus maprotiline in postherpetic neuralgia: a randomized double-blind crossover trial. Pain. 1992;48:29–36.PubMedCrossRefPubMedCentralGoogle Scholar
  95. 95.
    Spiegel K, Kalb R, Pasternak GW. Analgesic activity of tricyclic antidepressants. Ann Neurol. 1983;13:462–5.PubMedCrossRefPubMedCentralGoogle Scholar
  96. 96.
    Botney M, Fields HL. Amitriptyline potentiates morphine analgesia by direct action on the central nervous system. Ann Neurol. 1983;13:160–4.PubMedCrossRefPubMedCentralGoogle Scholar
  97. 97.
    Malseed RT, Goldstein FJ. Enhancement of morphine analgesics by tricyclic antidepressants. Neuropharmacology. 1979;18:827–9.PubMedCrossRefPubMedCentralGoogle Scholar
  98. 98.
    Ventafridda V, Bianchi M, Ripamonti C, Sacerdote P, De Conno F, Zecca E, Panerai AE. Studies on the effects of antidepressant drugs on the antinociceptive action of morphine and on plasma morphine in rat and man. Pain. 1990;43:155–62.PubMedCrossRefPubMedCentralGoogle Scholar
  99. 99.
    McQuay H, Carroll D, Glynn C. Dose-response for analgesic effect of amitriptyline in chronic pain. Anesthesia. 1993;48:281–5.CrossRefGoogle Scholar
  100. 100.
    Watson CP, Evans RJ. A comparative trial of amitriptyline and zimelidine in post-herpetic neuralgia. Pain. 1985;23:387–94.PubMedCrossRefPubMedCentralGoogle Scholar
  101. 101.
    Tasmuth T, Hartel B, Kalso E. Venlafaxine in neuropathic pain following treatment of breast cancer. Eur J Pain. 2002;6:17–24.PubMedCrossRefPubMedCentralGoogle Scholar
  102. 102.
    Özdogan M, Samur M, Bozcuk HŠ, Aydin H, Çoban E, Savaš B. Venlafaxine for treatment of chemotherapy-induced neuropathic pain. Turk J Cancer. 2004;34(3):24–31.Google Scholar
  103. 103.
    Reuben SS, Makari-Judson G, Lurie SD. Evaluation of efficacy of the perioperative administration of venlafaxine XR in the prevention of postmastectomy pain syndrome. J Pain Symptom Manag. 2004;27(2):133–9.CrossRefGoogle Scholar
  104. 104.
    Goldstein DJ, Lu Y, Detke MJ, Wiltse C, Mallinckrodt C, Demitrack MA. Duloxetine in the treatment of depression: a double-blind placebo-controlled comparison with paroxetine. J Clin Psychopharmacol. 2004;24(4):389–99.PubMedCrossRefPubMedCentralGoogle Scholar
  105. 105.
    Smith EML, Pang H, Cirrincione C, Fleishman S, Paskett ED, Ahles T, et al. Effect of duloxetine on pain, function, and quality of life among patients with chemotherapy-induced painful peripheral neuropathy: a randomized clinical trial. JAMA. 2013;309(13):1359–67.PubMedPubMedCentralCrossRefGoogle Scholar
  106. 106.
    Davidoff G, Guarracini M, Roth E, Sliwa J, Yarkony G. Trazodone hydrochloride in the treatment of dysesthetic pain in traumatic myelopathy: a randomized, double-blind, placebo-controlled study. Pain. 1987;29:151–61.PubMedCrossRefPubMedCentralGoogle Scholar
  107. 107.
    Costa D, Mogos I, Toma T. Efficacy and safety of mianserin in the treatment of depression of woman with cancer. Acta Psychiatr Scand. 1985;72:85–92.CrossRefGoogle Scholar
  108. 108.
    Eberhard G, von Knorring L, Nilsson HL, Sundequist U, Björling G, Linder H, Svärd KO, Tysk L. A double-blind randomized study of clomipramine versus maprotiline in patients with idiopathic pain syndromes. Neuropsychobiology. 1988;19:25–32.PubMedCrossRefPubMedCentralGoogle Scholar
  109. 109.
    Feighner JP. A comparative trial of fluoxetine and amitriptyline in patients with major depressive disorder. J Clin Psychiatry. 1985;46:369–72.PubMedPubMedCentralGoogle Scholar
  110. 110.
    Hynes MD, Lochner MA, Bemis KG, Hymson DL. Fluxoetine, a selective inhibitor of serotonin uptake, potentiates morphine analgesia without altering its descriminative stimulus properties or affinity for opioid receptors. Life Sci. 1985;36:2317–23.PubMedCrossRefGoogle Scholar
  111. 111.
    Stockler MR, O’Connell R, Nowak AK, Goldstein D, Turner J, Wilcken NR, et al. Effect of sertraline on symptoms and survival in patients with advanced cancer, but without major depression: a placebo-controlled double-blind randomised trial. Lancet Oncol. 2007;8(7):603–12.PubMedCrossRefGoogle Scholar
  112. 112.
    Fishbain D. Evidence-based data on pain relief with antidepressants. Ann Med. 2000;32(5):305–16.PubMedCrossRefGoogle Scholar
  113. 113.
    Lussier D, Huskey AG, Portenoy RK. Adjuvant analgesics in cancer pain management. Oncologist. 2004;9(5):571–91.PubMedCrossRefGoogle Scholar
  114. 114.
    Diamond S, Freitag FG. The use of fluoxetine in the treatment of headache. Clin J Pain. 1989;5:200–1.PubMedCrossRefGoogle Scholar
  115. 115.
    Geller SA. Treatment of fibrositis with fluoxetine hydrochloride (Prozac). Am J Med. 1989;87:594–5.PubMedCrossRefGoogle Scholar
  116. 116.
    Theesen KA, Marsh WR. Relief of diabetic neuropathy with fluoxetine. DICP, Ann Pharmacother. 1989;23:572–4.Google Scholar
  117. 117.
    Arnold LM, Hess EV, Hudson JI, Welge JA, Berno SE, Keck PE Jr. A randomized, placebo-controlled, double-blind, flexible-dose study of fluoxetine in the treatment of women with fibromyalgia. Am J Med. 2002;112(3):191–7.PubMedCrossRefGoogle Scholar
  118. 118.
    Sindrup SH, Gram LF, Brosen K, Eshoj O, Mogenson EF. The selective serotonin reuptake inhibitor paroxetine is effective in the treatment of diabetic neuropathy symptoms. Pain. 1990;42:135–44.PubMedCrossRefGoogle Scholar
  119. 119.
    Sindrup SH, Bjerre U, Dejgaard A, Brosen K, Aaes-Jorgensen T, Gram LF. The selective serotonin reuptake inhibitor citalopram relieves the symptoms of diabetic neuropathy. Clin Pharmacol Ther. 1992;52(5):547–52.PubMedCrossRefPubMedCentralGoogle Scholar
  120. 120.
    Sidney H, Kennedy HFA, Lam RW. Efficacy of escitalopram in the treatment of major depressive disorder compared with conventional selective serotonin reuptake inhibitors and venlafaxine XR: a meta-analysis. J Psychiatry Neurosci. 2006;31(2):122–31.Google Scholar
  121. 121.
    Theobald DE, Kirsh KL, Holtsclaw E, Donaghy K, Passik SD. An open-label, crossover trial of mirtazapine (15 and 30 mg) in cancer patients with pain and other distressing symptoms. J Pain Symptom Manag. 2002;23(5):442–7.CrossRefGoogle Scholar
  122. 122.
    Arnold P, Vuadens P, Kuntzer T, Gobelet C, Deriaz O. Mirtazapine decreases the pain feeling in healthy participants. Clin J Pain. 2008;24(2):116–9.PubMedCrossRefGoogle Scholar
  123. 123.
    Schreiber S, Rigai T, Katz Y, Pick CG. The antinociceptive effect of mirtazapine in mice is mediated through serotonergic, noradrenergic and opioid mechanisms. Brain Res Bull. 2002;58(6):601–5.PubMedCrossRefGoogle Scholar
  124. 124.
    Freynhagen R, Muth-Selbach U, Lipfert P, Stevens MF, Zacharowski K, Tolle TR, et al. The effect of mirtazapine in patients with chronic pain and concomitant depression. Curr Med Res Opin. 2006;22(2):257–64.PubMedCrossRefGoogle Scholar
  125. 125.
    Semenchuk MR, Sherman S, Davis B. Double-blind, randomized trial of bupropion SR for the treatment of neuropathic pain. Neurology. 2001;57(9):1583–8.PubMedCrossRefGoogle Scholar
  126. 126.
    Semenchuk MR, Davis B. Efficacy of sustained-release bupropion in neuropathic pain: an open-label study. Clin J Pain. 2000;16(1):6–11.PubMedCrossRefGoogle Scholar
  127. 127.
    Moss EL, Simpson JSA, Pelletier G, Forsyth P. An open-label study of the effects of bupropion SR on fatigue, depression and quality of life of mixed-site cancer patients and their partners. Psycho-Oncology. 2006;15(3):259–67.PubMedCrossRefGoogle Scholar
  128. 128.
    McDowell I, Lindsay J, Sykes E, Verreault R, Laurin D, Hendrie HC, et al. Bupropion sustained release treatment reduces fatigue in cancer patients. Can J Psychiatr. 2004;49:139–44.CrossRefGoogle Scholar
  129. 129.
    Mathias C, Mendes CC, de Sena EP, de Moraes ED, Bastos C, Braghiroli M, et al. An open-label, fixed-dose study of bupropion effect on sexual function scores in women treated for breast cancer. Ann Oncol. 2006;17(12):1792–6.PubMedCrossRefGoogle Scholar
  130. 130.
    Davis MP. Does trazodone have a role in palliating symptoms? Support Care Cancer. 2007;15(2):221–4.PubMedCrossRefGoogle Scholar
  131. 131.
    Fernandez F, Adams F, Holmes VF, Levy JK, Neidhart M. Methylphenidate for depressive disorders in cancer patients. Psychosomatics. 1987;28:455–61.PubMedCrossRefGoogle Scholar
  132. 132.
    Kaufmann MW, Murray GB, Cassem NH. Use of psychostimulants in medically ill depressive patients. Psychosomatics. 1982;23:817–9.PubMedCrossRefGoogle Scholar
  133. 133.
    Bruera E, Chadwick S, Brennels C, Hanson J, MacDonald RN. Methylphenidate associated with narcotics for the treatment of cancer pain. Cancer Treat Rep. 1987;71:67–70.PubMedGoogle Scholar
  134. 134.
    Bruera E, Brenneis C, Paterson AH, MacDonald RN. Use of methylphenidate as an adjuvant to narcotic analgesics in patients with advanced cancer. J Pain Symptom Manag. 1989;4:3–6.CrossRefGoogle Scholar
  135. 135.
    Bruera E, Fainsinger R, MacEachern T, Hanson J. The use of methylphenidate in patients with incident cancer pain receiving regular opiates: a preliminary report. Pain. 1992;50:75–7.PubMedCrossRefGoogle Scholar
  136. 136.
    Forrest WH Jr, Brown BW Jr, Brown CR, Defalque R, Gold M, Gordon HE, James KE, Katz J, Mahler DL, Schroff P, Teutsch G. Dextroamphetamine with morphine for the treatment of post-operative pain. N Engl J Med. 1977;296:712–5.PubMedCrossRefGoogle Scholar
  137. 137.
    Morrow GR, Shelke AR, Roscoe JA, Hickok JT, Mustian K. Management of cancer-related fatigue. Cancer Investig. 2005;23(3):229–39.CrossRefGoogle Scholar
  138. 138.
    DeBattista C, Lembke A, Solvason HB, Ghebremichael R, Poirier J. A prospective trial of modafinil as an adjunctive treatment of major depression. J Clin Psychopharmacol. 2004;24(1):87–90.PubMedCrossRefGoogle Scholar
  139. 139.
    Kingshott RN, Vennelle M, Coleman EL, Engleman HM, Mackay TW, Douglas NJ. Randomized, double-blind, placebo-controlled crossover trial of modafinil in the treatment of residual excessive daytime sleepiness in the sleep apnea/hypopnea syndrome. Am J Respir Crit Care Med. 2001;163(4):918–23.PubMedCrossRefGoogle Scholar
  140. 140.
    Rammohan KW, Rosenberg JH, Lynn DJ, Blumenfeld AM, Pollak CP, Nagaraja HN. Efficacy and safety of modafinil (Provigil) for the treatment of fatigue in multiple sclerosis: a two centre phase 2 study. J Neurol Neurosurg Psychiatry. 2002;72(2):179–83.PubMedPubMedCentralCrossRefGoogle Scholar
  141. 141.
    Myrick H, Malcolm R, Taylor B, LaRowe S. Modafinil: preclinical, clinical, and post-marketing surveillance-a review of abuse liability issues. Ann Clin Psychiatry. 2004;16(2):101–9.PubMedCrossRefGoogle Scholar
  142. 142.
    Volkow ND, Fowler JS, Logan J, Alexoff D, Zhu W, Telang F, et al. Effects of modafinil on dopamine and dopamine transporters in the male human brain: clinical implications. JAMA. 2009;301(11):1148–54.PubMedPubMedCentralCrossRefGoogle Scholar
  143. 143.
    Beaver WT, Wallenstein SL, Houde RW, Rogers A. A comparison of the analgesic effect of methotrimeprazine and morphine in patients with cancer. Clin Pharmacol Ther. 1966;7:436–46.PubMedCrossRefGoogle Scholar
  144. 144.
    Kennett A, Hardy J, Shah S, A’hern R. An open study of methotrimeprazine in the management of nausea and vomiting in patients with advanced cancer. Support Care Cancer. 2005;13(9):715–21.PubMedCrossRefGoogle Scholar
  145. 145.
    Maltbie AA, Cavenar JO Jr, Sullivan JL, Hammett EB, Zung WW. Analgesia and haloperidol: a hypothesis. J Clin Psychiatry. 1979;40:323–6.PubMedGoogle Scholar
  146. 146.
    Patt RB, Proper G, Reddy S. The neuroleptics as adjuvant analgesics. J Pain Symptom Manag. 1994;9(7):446–53.CrossRefGoogle Scholar
  147. 147.
    Lechin F, van der Dijs B, Lechin ME, Amat J, Lechin AE, Cabrera A, Gómez F, Acosta E, Arocha L, Villa S, et al. Pimozide therapy for trigeminal neuralgia. Arch Neurol. 1989;9:960–4.CrossRefGoogle Scholar
  148. 148.
    Boettger S, Breitbart W. Atypical antipsychotics in the management of delirium: a review of the empirical literature. Palliat Support Care. 2005;3(3):227–37.PubMedCrossRefGoogle Scholar
  149. 149.
    Sasaki Y, Matsuyama T, Inoue S, Sunami T, Inoue T, Denda K, et al. A prospective, open-label, flexible-dose study of quetiapine in the treatment of delirium. J Clin Psychiatry. 2003;64(11):1316–21.PubMedCrossRefGoogle Scholar
  150. 150.
    Leso L, Schwartz TL. Ziprasidone treatment of delirium. Psychosomatics. 2002;43(1):61–2.PubMedCrossRefGoogle Scholar
  151. 151.
    Boettger S, Breitbart W. An open trial of aripiprazole for the treatment of delirium in hospitalized cancer patients. Palliat Support Care. 2011;9(04):351–7.PubMedCrossRefGoogle Scholar
  152. 152.
    Alao AO, Moskowitz L. Aripiprazole and delirium. Ann Clin Psychiatry. 2006;18(4):267–9.PubMedCrossRefGoogle Scholar
  153. 153.
    Khojainova N, Santiago-Palma J, Kornick C, Breitbart W, Gonzales GR. Olanzapine in the management of cancer pain. J Pain Symptom Manag. 2002;23(4):346–50.CrossRefGoogle Scholar
  154. 154.
    Rumore MM, Schlichting DA. Clinical efficacy of antihistamines as analgesics. Pain. 1986;25:7–22.PubMedCrossRefGoogle Scholar
  155. 155.
    Hupert C, Yacoub M, Turgeon L. Effect of hydroxyzine on morphine analgesia for the treatment of postoperative pain. Anesth Analg. 1980;59(9):690–6.PubMedCrossRefGoogle Scholar
  156. 156.
    Fernandez F, Adams F, Holmes VF. Analgesic effect of alprazolam in patients with chronic, organic pain of malignant origin. J Clin Psychopharmacol. 1987;3:167–9.Google Scholar
  157. 157.
    Caccia MR. Clonazepam in facial neuralgia and cluster headache: clinical and electrophysiological study. Eur Neurol. 1975;13:560–3.PubMedCrossRefGoogle Scholar
  158. 158.
    Bartusch SL, Sanders JB, D’Alessio JG, Jernigan JR. Clonazepam for the treatment of lancinating phantom limb pain. Clin J Pain. 1996;12(1):59–62.PubMedCrossRefGoogle Scholar

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.University of Texas at Austin Dell Medical SchoolAustinUSA
  2. 2.Department of Psychiatry and Behavioral SciencesMemorial Sloan Kettering Cancer CenterNew YorkUSA

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