進行がん患者のうつ病に対してエスシタロプラムが有効であった2症例 [in Japanese] Two advanced cancer patients in whom escitalopram was useful for depression [in Japanese]
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<b>【目的】</b>進行がん患者のうつ病に対して,エスシタロプラム(ESC)が有効であった2症例を報告する. <b>【症例1】</b>50歳代, 男性, 直腸がん再発.The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR)にて大うつ病エピソードと診断, ハミルトンうつ病評価尺度(HAMD-17)は20点であった. ESC 10 mg/日を開始, 14日目より症状は改善し, 23日目のHAMD-17は4点に改善した. <b>【症例2】</b>50歳代, 女性,外耳道がん. DSM-IV-TRにて大うつ病エピソードと診断, HAMD-17は26点であった. ESC 10 mg/日を開始, 28日目のHAMD-17は13点に改善した. 両症例とも重篤な副作用やうつ病の再燃, 断薬による退薬症候群は認めなかった. <b>【結論】</b>ESCは進行がん患者のうつ病に対し, 有効な治療薬の1つとなる可能性がある.
<b>Purpose</b>: Escitalopram has been inadequately evaluated in cancer patients. Here, we report two patients with advanced cancer who benefited from escitalopram for depression. <b>Case 1</b>: A man aged in his 50s had postoperative recurrence of rectal cancer. He was diagnosed with a major depressive episode according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). The score of the Hamilton Rating Scale for Depression (HAMD-17) was 20 points. He began treatment with 10 mg/day of escitalopram. His symptoms began to improve at about 14 days, and the HAMD-17 score was 4 points at 23 days, suggesting a marked improvement. <b>Case 2</b>: A woman aged in her 50s had cancer of the external auditory canal. She was diagnosed with a major depressive episode according to DSM-IV-TR. The score of HAMD-17 was 26 points. She began treatment with 10 mg/day of escitalopram. Her symptoms began to improve at 15 days, and the HAMD-17 score at 28 days was 13 points, suggesting a marked improvement. In both cases, serious side effects, clear exacerbation of depression, and withdrawal syndrome due to acute drug deprivation associated with worsening of the symptoms were not noted. <b>Conclusion</b>: Escitalopram is considered a useful drug for depression in patients with advanced cancer.
- Palliative Care Research
Palliative Care Research 8(2), 548-553, 2013
Japanese Society for Palliative Medicine