Abstract
The diagnosis of any cancer is typically accompanied with instabilities of general health, disposition, and mood. Once the urgency of the cancer is addressed, additional health concerns, comorbidities, and conditions may be compromised and attention must be paid to these details in the context of the cancer. Mood disorders, including major depression and bipolar disorder, as well as distressful reactions are common and often ignored due to an inherent expectation of a sadness and distress associated with such a life-threatening disease. However, pathological mood swings are eminently treatable, and the management of mood disorders is particularly gratifying to the individual with cancer and rewarding for the practitioner. Adherence to treatment and improvements to quality of life are immediate, and enhancements in survivorship emerge over time. Bipolar disorder represents a particular challenge for the oncology team as gyrations of mood may jeopardize every aspect of management. This chapter discusses clinical strategies for the bipolar patient and includes the mood stabilizing and antipsychotic medications, emphasizing the need for regular monitoring of clinical mood symptoms, medication levels when possible, and physical health to gauge progress. Periods of unstable moods should be anticipated in the individual with concomitant cancer and specifically in the patient with bipolar disorder. Negotiating care involves clinical judgment at an interface of medicine wherein limited knowledge of pharmacological interactions is a major challenge; there are no clinical trials of mood management in the cancer patient with bipolar disorder. This chapter discusses the treatments of bipolar disorder and unstable moods in cancer.
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References
Allen MH, Hirschfeld RM, Wozniak PJ, Baker JD, Bowden CL. Linear relationship of valproate serum concentration to response and optimal serum levels for acute mania. Am J Psychiatry. 2006;163:272–5.
Anonymous. Practice guideline for the treatment of patients with major depressive disorder (revision). Am J Psychiatry. 2000;157:1–45
AP Association, STAT!Ref, Teton Data Systems. Diagnostic and statistical manual of mental disorders. Washington, DC: American Psychiatric Association; 2000.
Hopkins HS, Gelenberg AJ. Serum lithium levels and the outcome of maintenance therapy of bipolar disorder. Bipolar Disord. 2000;2:174–9.
Kessler RC, Berglund P, Demler O, Jin R, Koretz D, Merikangas KR, Rush AJ, Walters EE, Wang PS, National Comorbidity Survey Replication. The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA. 2003;289:3095–105.
Malhi GS, Mitchell PB, Salim S. Bipolar depression: management options. CNS Drugs. 2003;17:9–25.
Malhi GS, Adams D, Berk M. Medicating mood with maintenance in mind: bipolar depression pharmacotherapy. Bipolar Disord. 2009;11 Suppl 2:55–76.
Mann JJ. The medical management of depression. N Engl J Med. 2005;353:1819–34.
Marder SR, Essock SM, Miller AL, Buchanan RW, Casey DE, Davis JM, Kane JM, Lieberman JA, Schooler NR, Covell N, Stroup S, Weissman EM, Wirshing DA, Hall CS, Pogach L, Pi-Sunyer X, Bigger Jr JT, Friedman A, Kleinberg D, Yevich SJ, Davis B, Shon S. Physical health monitoring of patients with schizophrenia. Am J Psychiatry. 2004;161:1334–49.
McEvoy GK, Miller J, Snow EK, et al. Carbamazepine. AHFS Drug Information 2007. Bethesda, MD: American Society of Health-System Pharmacists; 2007a. p. 2220–5
McEvoy GK, Miller J, Snow EK, et al. Lamotrigine. AHFS Drug Information 2007. Bethesda, MD: American Society of Health-System Pharmacists; 2007b. p. 2233–9
Merikangas KR, Akiskal HS, Angst J, Greenberg PE, Hirschfeld RM, Petukhova M, Kessler RC. Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey replication. Arch Gen Psychiatry. 2007;64:543–52.
Perlis RH. The role of pharmacologic treatment guidelines for bipolar disorder. J Clin Psychiatry. 2005;66 Suppl 3:37–47.
Suppes T, Dennehy EB, Hirschfeld RM, Altshuler LL, Bowden CL, Calabrese JR, Crismon ML, Ketter TA, Sachs GS, Swann AC, Texas Consensus Conference Panel on Medication Treatment of Bipolar Disorder. The Texas implementation of medication algorithms: update to the algorithms for treatment of bipolar I disorder. J Clin Psychiatry. 2005;66:870–86.
Tohen M, Vieta E. Antipsychotic agents in the treatment of bipolar mania. Bipolar Disord. 2009;11 Suppl 2:45–54.
Yatham LN, Kennedy SH, Parikh SV, Schaffer A, Beaulieu S, Alda M, O'Donovan C, Macqueen G, McIntyre RS, Sharma V, Ravindran A, Young LT, Milev R, Bond DJ, Frey BN, Goldstein BI, Lafer B, Birmaher B, Ha K, Nolen WA, Berk M. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2013. Bipolar Disord. 2013;15:1–44.
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Hertz, D.L., Ellingrod, V.L., McInnis, M.G. (2014). Bipolar Disorder in the Cancer Patient. In: Grassi, L., Riba, M. (eds) Psychopharmacology in Oncology and Palliative Care. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-40134-3_11
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DOI: https://doi.org/10.1007/978-3-642-40134-3_11
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