Depression:spectrum from response to a crisis → adjustment disorder → major depressive disorder.
Under-recognized and under-treated.
Good screening tool for all ages with advanced disease is geriatric depression scale.
Drugs
Methylphenidate
- useful in patients with short life expectancy
SNRI-venlafaxine, duloxetine
- helpful with neuropathic pain
Mirtazepine
(atypical)
- helpful with neuropathic pain, insomnia, appetite
SSRI
- for depression without co-existing pain
TCA
- side effects limit use
Other therapies
- supportive psychological and spiritual counseling