Depression After Youth Cancer Battle

Antidepressant use rates higher in adults treated for cancer before adulthood

(RxWiki News) Does having cancer while growing up increase the odds of depression later in life? If so, there’s no shame in reaching out for help with mental health issues.

A recent study looked at the rates of antidepressant medication usage in people who had battled cancer before the age of 25 and compared those rates to those in people who had never had cancer. The study’s findings did show higher rates of antidepressant prescriptions for the former cancer patients, even if they had beat cancer over 20 years ago.

"Talk to a therapist about any mental health symptoms."

Rebecca J. Deyell, MD, MHSc, from the Division of Oncology, Hematology and Bone Marrow Transplant at British Columbia Children’s Hospital and University of British Columbia in Vancouver, Canada, worked with a team of colleagues for the investigation.

For the study, 2,389 people who had been diagnosed with cancer before the age of 25 and were still alive at least 5 years later were selected. They were located from a health insurance registry between 2001-2004.

A group of 23,890 non-cancer patients were compared to the former-cancer group. The non-cancer group was age and gender matched to the former-cancer group for similarity in comparison.

Researchers verified all prescription medications through the health insurance registry.

Prescription antidepressant use was compared between the two population groups.

Analysis showed that former child, adolescent and young adult cancer patients were roughly 1.2 times more likely to have taken antidepressants compared to the non-cancer group.

Former cancer patients were roughly 1.3 times more likely than non-cancer counterparts to take pharmaceuticals from two or more antidepressant categories.

The type of cancer treatment used did not influence antidepressant usage.

Former cancer patients showed higher rates of antidepressant use if they were female, in young adulthood at the time of cancer and/or more than 20 years post-treatment for cancer.

Authors concluded, “Survivors of childhood, adolescent and young adult cancer are more likely to fill antidepressant prescriptions compared to peer controls. This may indirectly reflect an increased underlying prevalence of mental health conditions among survivors.”

Shelli Kesler, PhD, Assistant Professor of Psychiatry at Stanford University and dailyRx Contributing Expert, said, "In addition to the obvious stress of dealing with a life threatening illness and the disruption this can cause in one's life, cancer and its treatments (e.g. chemotherapy, radiation, etc.) can actually alter certain hormones in the body that regulate mood and stress response."

"For example, previous research has shown that individuals with cancer have altered patterns of cortisol, a hormone involved in mood and stress. Cancer and chemotherapy also increase inflammation which is associated with increased depression. Additionally, chemotherapy has been associated with brain changes in regions of the brain that are responsible for mood and emotional regulation."

"In summary, increased depression among cancer survivors has both psychological and physiological factors and therefore it is important that these children and youth receive appropriate mental health care to determine if medications such as antidepressants can be helpful in reducing symptoms of depression."

This study was published in December in Pediatric Blood & Cancer.

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