Depression

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

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