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Depression (PDQ®): Supportive care - Patient Information [NCI] - Treatment of Depression

The decision to treat depression depends on how long it has lasted and how much it affects your life.

If you cannot adjust to the cancer diagnosis after a long time and you have lost interest in your usual activities, you may have depression that needs to be treated. Treatment of depression may include medicines, talk therapy, or both.

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Treatment of major depression usually includes medicine.

It's important to use antidepressants only under the care of a doctor.

Antidepressants help relieve depression and its symptoms. When you are taking antidepressants, it's important that they are used under the care of a doctor. You may be treated with a number of medicines during your cancer care. Some anticancer medicines may not mix safely with certain antidepressants or with certain foods, herbals, or nutritional supplements. It's important to tell your healthcare providers about all the medicines, herbals, and nutritional supplements you are taking, including medicines used as patches on the skin. This can help prevent unwanted reactions.

Many antidepressants take from 3 to 6 weeks to work. Usually, you begin at a low dose that is slowly increased to find the right dose for you. This helps to avoid side effects.

Check with your doctor before you stop taking an antidepressant. You may need to slowly reduce the dose of some types of antidepressants. This is to prevent side effects you may have if you suddenly stop taking the medicine.

There are different types of antidepressants.

Most antidepressants help treat depression by changing the levels of chemicals called neurotransmitters in the brain. Nerves use these chemicals to send messages to one another. Increasing the amount of these chemicals helps to improve mood. The different types of antidepressants act on these chemicals in different ways and have different side effects.

Three types of antidepressants are commonly used to treat depression in patients with cancer:

  • SSRIs (selective serotonin reuptake inhibitors): Medicines that increase the brain chemical serotonin.
  • Tricyclic antidepressants: Medicines that increase the brain chemicals serotonin and norepinephrine.
  • Central nervous system (CNS) stimulants: Medicines that increase the brain chemicals dopamine and norepinephrine.

There are other types of antidepressants that may be used:

The antidepressant that is best for you depends on the following:

  • Your symptoms.
  • Your medical problems.
  • Possible side effects of the antidepressant.
  • The form of medicine you are able to take (such as a pill or a liquid).
  • Other medicines you are taking.
  • How you responded to antidepressants in the past.

St. John's wort may change the way some of your other medicines work.

St. John's wort (Hypericum perforatum) is an herbal product sold as an over-the-counter treatment for depression. St. John's wort has not been proven to be better than standard antidepressant medicines. Many studies have been done to compare St. John's wort with antidepressants, placebo (inactive) medicines, or both, and have shown mixed results.

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WebMD Public Information from the National Cancer Institute

Last Updated: February 25, 2014
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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