Nihon rinsho. Japanese journal of clinical medicine
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Pharmacology, clinical efficacy and tolerability of serotonin noradrenaline reuptake inhibitors(SNRIs) are overviewed. They include milnacipran, venlafaxine, duloxetine, MCI-225 and nefazodone, however, only milnacipran is currently used in Japan. ⋯ SNRIs are well tolerated in general and safer than TCAs. SNRIs can be considered to be first-line antidepressant drugs.
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Depression in cancer patients is common and occurs throughout the course of cancer illness. We review diagnosing, treatment and palliative care issues as well as epidemiology and etiology of major depression in cancer patients. The prevalence of major depression in cancer patients was reported to range from 6 to 42%. ⋯ To avoid under-diagnosing depression in cancer patient, it should include not only psychological symptoms, but also physical symptoms. The treatment includes patient education, counseling, behavioral techniques and antidepressant medications. In palliative care setting, life review interview would be effective for depression.