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Psychopharmacology in Oncology and Palliative Care pp 381–391Cite as

Research Issues in Psychopharmacology in Oncology and Palliative Care Settings

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Abstract

Psychopharmacologic interventions are commonly used in oncology and palliative care settings. However, there have been relatively few rigorously designed and conducted psychopharmacologic studies in these patient populations. Given a growing recognition of the importance of identifying and treating varied forms of distress in cancer patients and survivors, there is an urgent need to develop a more robust evidence base to guide psychopharmacologic treatment decisions. Such an evidence base would help address stigma regarding psychopharmacologic treatments as well as help clinicians working in psycho-oncology to educate their oncology colleagues. In addition to reviewing the rationale for psychopharmacologic research in psycho-oncology, this chapter describes a number of areas that are ripe for psychopharmacologic research in psycho-oncology, for example: efficacy and tolerability of antipsychotics for mood, anxiety, or insomnia; antipsychotic use in delirium; and psychostimulant use for fatigue and cognitive effects of cancer treatments. This chapter also reviews limitations of existing research on psychopharmacologic treatments in psycho-oncology. Suggestions for future research are provided, in the interest of providing “real-world” effectiveness data for the management of the numerous common symptoms and syndromes that occur in cancer patients and survivors. Examples include the study of co-occurring symptoms (e.g., depression and fatigue), research on the treatment of so-called subsyndromal levels of depressive or anxiety symptoms, and studies of specific treatments in specific cancer populations.

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References

  • Breitbart W, Alici Y. Evidence-based treatment of delirium in patients with cancer. J Clin Oncol. 2012;30(11):1206–14.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Breitbart W, Poppito S, Rosenfeld B, Vickers AJ, Li Y, Abbey J, Olden M, Pessin H, Lichtenthal W, Sjoberg D, Cassileth BR. Pilot randomized controlled trial of individual meaning-centered psychotherapy for patients with advanced cancer. J Clin Oncol. 2012;30(12):1304–9.

    Article  PubMed Central  PubMed  Google Scholar 

  • Bruera E, Valero V, Driver L, Shen L, Willey J, Zhang T, Palmer JL. Patient-controlled methylphenidate for cancer fatigue: a double-blind, randomized, placebo-controlled trial. J Clin Oncol. 2006;24(13):2073–8.

    Article  CAS  PubMed  Google Scholar 

  • Candy B, Jackson KC, Jones L, Tookman A, King M. Drug therapy for symptoms associated with anxiety in adult palliative care patients. Cochrane Database Syst Rev. 2012;10, CD004596.

    PubMed  Google Scholar 

  • Carlson LE, Waller A, Mitchell AJ. Screening for distress and unmet needs in patients with cancer: review and recommendations. J Clin Oncol. 2012;30(11):1160–77.

    Article  PubMed  Google Scholar 

  • Chochinov HM. Depression in cancer patients. Lancet Oncol. 2001;2(8):499–505.

    Article  CAS  PubMed  Google Scholar 

  • Dunn LB, Cooper BA, Neuhaus J, West C, Paul S, Aouizerat B, Abrams G, Edrington J, Hamolsky D, Miaskowski C. Identification of distinct depressive symptom trajectories in women following surgery for breast cancer. Health Psychol. 2011;30(6):683–92.

    Article  PubMed Central  PubMed  Google Scholar 

  • Fann JR, Ell K, Sharpe M. Integrating psychosocial care into cancer services. J Clin Oncol. 2012;30(11):1178–86.

    Article  PubMed  Google Scholar 

  • Hart SL, Hoyt MA, Diefenbach M, Anderson DR, Kilbourn KM, Craft LL, Steel JL, Cuijpers P, Mohr DC, Berendsen M, Spring B, Stanton AL. Meta-analysis of efficacy of interventions for elevated depressive symptoms in adults diagnosed with cancer. J Natl Cancer Inst. 2012;104(13):990–1004.

    Article  PubMed Central  PubMed  Google Scholar 

  • Hoffman CJ, Ersser SJ, Hopkinson JB, Nicholls PG, Harrington JE, Thomas PW. Effectiveness of mindfulness-based stress reduction in mood, breast- and endocrine-related quality of life, and well-being in stage 0 to III breast cancer: a randomized, controlled trial. J Clin Oncol. 2012;30(12):1335–42.

    Article  PubMed  Google Scholar 

  • Holland JC. History of psycho-oncology: overcoming attitudinal and conceptual barriers. Psychosom Med. 2002;64(2):206–21.

    Article  PubMed  Google Scholar 

  • Holland JC, Andersen B, Breitbart WS, Dabrowski M, Dudley MM, Fleishman S, Foley GV, Fulcher C, Greenberg DB, Greiner CB, Handzo RG, Jacobsen PB, Knight SJ, Learson K, Levy MH, Manne S, McAllister-Black R, Peterman A, Riba MB, Slatkin NE, Valentine A, Zevon MA, NCCN. Distress management. J Natl Compr Canc Netw. 2007;5(1):66–98.

    PubMed  Google Scholar 

  • Institute of Medicine. Cancer care for the whole patient: meeting psychosocial health needs. Washington, DC: The National Academies Press; 2007.

    Google Scholar 

  • Irwin KE, Greer JA, Khatib J, Temel JS, Pirl WF. Early palliative care and metastatic non-small cell lung cancer: potential mechanisms of prolonged survival. Chron Respir Dis. 2013;10(1):35–47.

    Article  PubMed  Google Scholar 

  • Jacobsen PB, Ransom S. Implementation of NCCN distress management guidelines by member institutions. J Natl Compr Canc Netw. 2007;5(1):99–103.

    PubMed  Google Scholar 

  • Jacobsen PB, Donovan KA, Swaine ZN, et al. Management of anxiety and depression in adult cancer patients: toward an evidence-based approach. In: Chang AE, Ganz PA, Hayes DF, et al., editors. Oncology: an evidence-based approach. New York: Springer; 2006. p. 1552–79.

    Google Scholar 

  • Jacobsen PB, Holland JC, Steensma DP. Caring for the whole patient: the science of psychosocial care. J Clin Oncol. 2012;30(11):1151–3.

    Article  PubMed  Google Scholar 

  • Krystal JH, Sanacora G, Duman RS. Rapid-acting glutamatergic antidepressants: the path to ketamine and beyond. Biol Psychiatry. 2013;73(12):1133–41.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Laoutidis ZG, Mathiak K. Antidepressants in the treatment of depression/depressive symptoms in cancer patients: a systematic review and meta-analysis. BMC Psychiatry. 2013;13:140.

    Article  PubMed Central  PubMed  Google Scholar 

  • Li M, Fitzgerald P, Rodin G. Evidence-based treatment of depression in patients with cancer. J Clin Oncol. 2012;30(11):1187–96.

    Article  PubMed  Google Scholar 

  • Massie MJ. Prevalence of depression in patients with cancer. J Natl Cancer Inst Monogr. 2004;32:57–71.

    Article  PubMed  Google Scholar 

  • Northouse L, Williams AL, Given B, McCorkle R. Psychosocial care for family caregivers of patients with cancer. J Clin Oncol. 2012;30(11):1227–34.

    Article  PubMed  Google Scholar 

  • Phelps AC, Lauderdale KE, Alcorn S, Dillinger J, Balboni MT, Van Wert M, Vanderweele TJ, Balboni TA. Addressing spirituality within the care of patients at the end of life: perspectives of patients with advanced cancer, oncologists, and oncology nurses. J Clin Oncol. 2012;30(20):2538–44.

    Article  PubMed  Google Scholar 

  • Pirl WF, Greer JA, Traeger L, Jackson V, Lennes IT, Gallagher ER, Perez-Cruz P, Heist RS, Temel JS. Depression and survival in metastatic non-small-cell lung cancer: effects of early palliative care. J Clin Oncol. 2012;30(12):1310–5.

    Article  PubMed Central  PubMed  Google Scholar 

  • Rayner L, Price A, Evans A, Valsraj K, Hotopf M, Higginson IJ. Antidepressants for the treatment of depression in palliative care: systematic review and meta-analysis. Palliat Med. 2011;25(1):36–51.

    Article  PubMed  Google Scholar 

  • Rush AJ, Trivedi MH, Wisniewski SR, Nierenberg AA, Stewart JW, Warden D, Niederehe G, Thase ME, Lavori PW, Lebowitz BD, McGrath PJ, Rosenbaum JF, Sackeim HA, Kupfer DJ, Luther J, Fava M. Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report. Am J Psychiatry. 2006;163(11):1905–17.

    Article  PubMed  Google Scholar 

  • Sheinfeld Gorin S, Krebs P, Badr H, Janke EA, Jim HS, Spring B, Mohr DC, Berendsen MA, Jacobsen PB. Meta-analysis of psychosocial interventions to reduce pain in patients with cancer. J Clin Oncol. 2012;30(5):539–47.

    Article  PubMed  Google Scholar 

  • Sood A, Barton DL, Loprinzi CL. Use of methylphenidate in patients with cancer. Am J Hosp Palliat Care. 2006;23(1):35–40.

    Article  PubMed  Google Scholar 

  • Temel JS, Greer JA, Muzikansky A, Gallagher ER, Admane S, Jackson VA, Dahlin CM, Blinderman CD, Jacobsen J, Pirl WF, Billings JA, Lynch TJ. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med. 2010;363(8):733–42.

    Article  CAS  PubMed  Google Scholar 

  • Traeger L, Greer JA, Fernandez-Robles C, Temel JS, Pirl WF. Evidence-based treatment of anxiety in patients with cancer. J Clin Oncol. 2012;30(11):1197–205.

    Article  PubMed  Google Scholar 

  • Trask PC. Assessment of depression in cancer patients. J Natl Cancer Inst Monogr. 2004;414(32):80–92.

    Google Scholar 

  • Zabora J, BrintzenhofeSzoc K, Curbow B, Hooker C, Piantadosi S. The prevalence of psychological distress by cancer site. Psychooncology. 2001;10(1):19–28.

    Article  CAS  PubMed  Google Scholar 

  • Zarate Jr CA, Singh JB, Carlson PJ, Brutsche NE, Ameli R, Luckenbaugh DA, Charney DS, Manji HK. A randomized trial of an N-methyl-D-aspartate antagonist in treatment-resistant major depression. Arch Gen Psychiatry. 2006;63(8):856–64.

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, 7th Floor, New York, NY, 10022, USA

    Yesne Alici

  2. Department of Psychiatry, University of California, San Francisco, 401 Parnassus Avenue, 0984-F, San Francisco, CA, 94002, USA

    Laura B. Dunn

Authors
  1. Yesne Alici
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  2. Laura B. Dunn
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Corresponding author

Correspondence to Yesne Alici .

Editor information

Editors and Affiliations

  1. Biomedical & Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy

    Luigi Grassi

  2. Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA

    Michelle Riba

Appendices

Key References

  • Breitbart W, Alici Y. Evidence-based treatment of delirium in patients with cancer. J Clin Oncol. 2012b;30(11):1206–14.

  • Hart SL, Hoyt MA, Diefenbach M, Anderson DR, Kilbourn KM, Craft LL, Steel JL, Cuijpers P, Mohr DC, Berendsen M, Spring B, Stanton AL. Meta-analysis of efficacy of interventions for elevated depressive symptoms in adults diagnosed with cancer. J Natl Cancer Inst. 2012b;104(13):990–1004.

  • Krystal JH, Sanacora G, Duman RS. Rapid-acting glutamatergic antidepressants: the path to ketamine and beyond. Biol Psychiatry. 2013b;73(12):1133–41.

  • Li M, Fitzgerald P, Rodin G. Evidence-based treatment of depression in patients with cancer. J Clin Oncol. 2012b;30(11):1187–96.

  • Rayner L, Price A, Evans A, Valsraj K, Hotopf M, Higginson IJ. Antidepressants for the treatment of depression in palliative care: systematic review and meta-analysis. Palliat Med. 2011b;25(1):36–51.

  • Traeger L, Greer JA, Fernandez-Robles C, Temel JS, Pirl WF. Evidence-based treatment of anxiety in patients with cancer. J Clin Oncol. 2012b;30(11):1197–205.

Suggested Further Reading

  • Billings JA, Block SD. Integrating psychiatry and palliative medicine: the challenges and opportunities. In: Chochinov HM, Breitbart WS, editors. Handbook of psychiatry in palliative medicine. 2nd ed. New York: Oxford; 2009. p. 13–21.

  • Holland JC, Weiss TR. History of psycho-oncology. In: Holland JH, Breitbart W, editors. Psycho-oncology. 2nd ed. New York: Oxford; 2010. p. 3–14.

  • Jacobsen PB. Translating psychosocial oncology research to clinical practice. In: Holland JH, Breitbart W, editors. Psycho-oncology. 2nd ed. New York: Oxford; 2010. p. 642–7.

  • Johansen C, Grassi L. International psycho-oncology: present and future. In: Holland JH, Breitbart W, editors. Psycho-oncology. 2nd ed. New York: Oxford; 2010. p. 655–62.

  • Rosenstein DL, Miller FG. Research ethics in psycho-oncology. In: Holland JH, Breitbart W, editors. Psycho-oncology. 2nd ed. New York: Oxford; 2010. p. 630–5.

  • Stefanek M. Basic and translational psycho-oncology research. In: Holland JH, Breitbart W, editors. Psycho-oncology. 2nd ed. New York: Oxford; 2010. p. 637–41.

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Alici, Y., Dunn, L.B. (2014). Research Issues in Psychopharmacology in Oncology and Palliative Care Settings. In: Grassi, L., Riba, M. (eds) Psychopharmacology in Oncology and Palliative Care. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-40134-3_21

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  • DOI: https://doi.org/10.1007/978-3-642-40134-3_21

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-40133-6

  • Online ISBN: 978-3-642-40134-3

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