Hi everyone,
I am finding some conflicting information on whether antidepressants with seratonin can contribute to progression. My husband is on a small dose of sertraline (Zoloft) every day. Is this something we should hold? I have for now as the dose is very small...
Any natural antidepressants that might be worth trying?
Thanks!
Abby
Most of the evidence I've seen has been favorable towards selective serotinin reuptake inhibiting (SSRI) antidepressants such as Zoloft and Prozac (fluoxetine).
ReplyDeletehttps://www.ncbi.nlm.nih.gov/pubmed/20859197
In this retrospective study, brain tumor patients who were on an SSRI antidepressant had better survival, which in multivariate analysis after adjusting for age, RPA class, and extent of resection, had statistical significance.
Mouse studies also show a benefit:
https://www.ncbi.nlm.nih.gov/pubmed/25671301 (Fluoxetine)
https://www.ncbi.nlm.nih.gov/pubmed/20354178 (The antidepressant sertraline inhibits translation initiation by curtailing mammalian target of rapamycin signaling)
Based on evidence such as this, sertraline is included in the CUSP9 protocol (https://clinicaltrials.gov/ct2/show/NCT02770378) which is active in Germany, and fluoxetine (Prozac) was included in the CUSP-ND proposal (which remains untested in humans). http://www.anticanceralliance.com/cusp-nd/
As for natural antidepressants, I find the recent clinical trials on psilocybin (active ingredient in "magic mushrooms" quite interesting. It has shown psychotherapeutic benefit in advanced cancer patients, as well as cases of treatment-resistant depression.
https://www.ncbi.nlm.nih.gov/pubmed/29387009
Quality of Acute Psychedelic Experience Predicts Therapeutic Efficacy of Psilocybin for Treatment-Resistant Depression.
https://www.ncbi.nlm.nih.gov/pubmed/29119217
Psilocybin with psychological support for treatment-resistant depression: six-month follow-up
https://www.ncbi.nlm.nih.gov/pubmed/27909164
Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial.
https://www.ncbi.nlm.nih.gov/pubmed/27909165
Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial.
However I can't responsibly recommend this to brain tumor patients, as it hasn't been tested in such a setting, and we don't know how it would influence, for example, seizure activity, or tumor biology. Like SSRI antidepressants, classic psychadelics work on the serotonin system (psilocybin is a 5-HT2A serotonin receptor agonist).
Hi Stephen, have you heard of patients using Celexa? We were doing clomipramine but it has too many side effects, so we were prescribed Celexa for my Mom.
DeleteCelexa, or citalopram, is a selective serotonin reuptake inhibitor, so is closer to other SSRIs such as Prozac (fluoxetine) and Zoloft (sertraline), than to a tricyclic antidepressant like clomipramine. I haven't heard of GBM patients using citalopram in GBM cocktails, but a number of people are using Prozac or Zoloft in their cocktails.
DeleteProzac (fluoxetine) has several mouse studies to support its use in GBM.
https://www.ncbi.nlm.nih.gov/pubmed/25671301
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4550181/
Zoloft (sertraline) is included in the CUSP9 protocol.
Thanks Stephen, good to know, I will discuss these different options with our NO.
Deleteto relieve myself of the anxiety I've used posirive affirmations, written and meditated on walong with gtwtitudes each day
ReplyDeleteI would second Leanne's comment. I'm a type A personality and never was one to be into meditation type stuff. But I went ahead and tried it some and was pleasantly surprised to find that meditation and yoga had a pretty big impact. Very calming, significantly helped stabilize mood and just seemed to have a clearer mind.
ReplyDelete