Walker and coworkers143 found higher scores in the Hospital Anxiety and Depression Scale in patients receiving IL-2 Vandetanib IC50 therapy used for advanced colorectal cancer (compared with those on standard chemotherapy). Finally, Capuron and colleagues144 found elevated depression scores in patients receiving IL-2, potentially reflecting authentic changes in mood

states rather than somatic symptoms alone. In a later study, the same authors showed that mood symptoms correlated with increased serum cytokine levels during treatment.145 CAL-101 Corticosteroids Corticosteroids are used to treat the symptoms of a number of neurologic (eg, MS), rheumatologic (eg, rheumatoid arthritis), gastrointestinal Inhibitors,research,lifescience,medical (eg, Crohn’s disease, ulcerative Inhibitors,research,lifescience,medical colitis), and respiratory (eg, chronic obstructive pulmonary disease, asthma) diseases characterized by excessive inflammation. They also are commonly indicated in oncologic patients, both to reduce inflammation around tumors as well as to reduce the side effects induced by chemotherapy agents. These agents have

been associated with a broad range Inhibitors,research,lifescience,medical of neuropsychiatric symptoms, varying from subtle anxiety/depression to full-blown affective and psychotic disorders. Early studies suggested these side effects were dose-dependent.146 Depressive disorders are commonly associated Inhibitors,research,lifescience,medical with long-term corticosteroid therapy. One study found that chronic corticosteroid-treated patients had significantly greater depressive symptom severity as well as global psychiatric symptom severity, and a 60% lifetime risk for mood and anxiety disorders.147 Breitbart and associates148 examined the impact of steroids in cancer patients, and found an increased incidence of depressive disorders in patients receiving high-dose dexamethasone for the treatment of spinal cord compression. The authors noted psychological stress increased as the dosage was tapered, and it was difficult to determine Inhibitors,research,lifescience,medical whether

symptoms resulted from Batimastat dose-reduction of cumulative steroid exposure. Corticosteroids are thought to induce mood symptoms by elevating plasma cortisol concentrations; interestingly, hypothalamic-pituitaryadrenal axis dysfunction has been strongly associated with the development of depression in cancer patients. Tyrosine kinase inhibitors Tyrosine kinase inhibitors have potent activity against a variety of tyrosine kinases, each with specific molecular targets and mechanisms of action. The prescribing information for several of these agents lists depression as an adverse effect. Early trials of imanitib found depressed mood to occur in 7% to 15% patients, with more severe depressive symptoms (with significant dysfunction or suicidal ideation) occurring in less than 1% of patients.