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首页> 外文期刊>Tumori. >Pharmacogenetics of escitalopram and mental adaptation to cancer in palliative care: report of 18 cases.
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Pharmacogenetics of escitalopram and mental adaptation to cancer in palliative care: report of 18 cases.

机译：依西酞普兰的药物遗传学和姑息治疗中的心理适应性癌症：18例报告。

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AIMS AND BACKGROUND: In palliative care, few data are available on the diagnosis and treatment of mood disorders and of difficulties of mental adaptation to cancer for patients in the advanced phases of the disease. SSRI antidepressants are the treatment of choice; the 5-HTTLPR genetic polymorphism of the serotonin transporter (SERT) has been shown in psychiatry to significantly determine the therapeutic response and the incidence of adverse effects. The aim of the present investigation has been therefore to examine the effects of the SSRI antidepressant escitalopram, also considering 5-HTTLPR, on depression, anxiety and mental adaptation to cancer in palliative care. METHODS AND STUDY DESIGN: Eighteen consecutive depressed patients with different forms of advanced cancer admitted to the Hospice Ass 6 of S. Vito al Tagliamento (Pordenone, Italy) were genotyped for the "s" and "l" variants of 5-HTTLPR and were treated with escitalopram. Their response after two weeks of treatment was psychometrically evaluated. RESULTS: Treatment with escitalopram significantly decreased anxiety scores on the Hospital Anxiety and Depression Scale (HADS) (P = 0.006) as well as anxious preoccupation (P = 0.007) and hopelessness-helplessness (P = 0.017) scores on the Mini Mental Adjustment to Cancer (Mini-MAC) scale. When patients were stratified by SERT genotype, HADS anxiety was significantly decreased in patients carrying the "s/s" and "s/l" variants (P = 0.024), whereas those with an l/l preoccupation (P = 0.018). CONCLUSIONS: The results of this study indicate that the use of SSRI antidepressants is effective in the palliative care of cancer patients, and their action affects not only depression but also the patients' mental adaptation to the disease. These results encourage further examination of these drugs in a larger cohort of patients. The significant contribution of pharmacogenetics indicates the possibility of personalized treatment with SSRIs in palliative care.
机译：目的和背景：在姑息治疗中，关于疾病晚期患者的情绪障碍的诊断和治疗以及心理适应癌症的困难的数据很少。 SSRI抗抑郁药是首选治疗方法; 5-羟色胺转运蛋白（SERT）的5-HTTLPR遗传多态性已在精神病学中显示，可显着确定治疗反应和不良反应的发生率。因此，本研究的目的是检查SSRI抗抑郁药依他普仑（也考虑使用5-HTTLPR）对姑息治疗中的抑郁症，焦虑症和心理适应性的影响。方法和研究设计：18名连续住院的患有不同形式的晚期癌症的抑郁患者被S. Vito al Tagliamento（意大利，Pordenone，意大利）的临终关怀协会第6医院分型，分别是5-HTTLPR的“ s”和“ l”变体，分别为用依他普仑治疗。在心理上评估了治疗两周后的反应。结果：艾司西酞普兰治疗显着降低了医院焦虑和抑郁量表（HADS）的焦虑评分（P = 0.006）以及焦虑前瞻性（P = 0.007）和绝望无助（P = 0.017）评分。癌症（Mini-MAC）规模。当按SERT基因型对患者进行分层时，携带“ s / s”和“ s / l”变体的患者的HADS焦虑显着降低（P = 0.024），而具有l / l专注的患者（P = 0.018）。结论：本研究结果表明SSRI抗抑郁药在癌症患者的姑息治疗中是有效的，其作用不仅影响抑郁症，还影响患者对疾病的心理适应性。这些结果鼓励在更大范围的患者群体中进一步检查这些药物。药物遗传学的重大贡献表明，在姑息治疗中使用SSRI进行个性化治疗的可能性。

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