P132: Efficacy of Vortioxetine in Major Depression in Terminal Cancer. About a Case

Abstract

Introduction:

Major depression is one of the most widely recognized psychiatric disorders in cancer patients. In Spain,16.49% of cancer patients develop a Major Depressive Disorder. It arises as a reaction to a traumatic experience influenced by events and environmental conditions and develops as a consequence, of an adverse event, whether single or recurring. When depressive symptoms interfere with the proper functioning of cancer patients, antidepressants are the first line of treatment. We refer to Vortioxetine as the antidepressant of choice.

Medical History:

We present a 68-year-old patient diagnosed with Prostate Neoplasm (Gleason Grade 6 STAGE IV Adenocarcinoma) with Bone and Pulmonary Metastasis, who was referred, to the PADES Service of CSS Bernat Jaume, for poor pain control at the L5-L7 lumbar spine level. (VAS 9/10), immobility and depression after his prognostic information and short-term expectations.

We want to assess the usefulness of Vortioxetine for depression in cancer terminal patients. The diagnostic criteria for depressive disorder were evaluated according to the DSM-V(6) risk factors for depression in palliative patients. The Visual Analogue Scale for the evaluation of the pain (0 no pain and 10, unbearable pain). Previously used medications for pain control, and depression were assessed. It was decided to start treatment with Vortioxetine and assess the response.

Treatment:

We started Vortioxetine 5 mg for a week and appetite improved, as well as VAS 5/10. After fifteen days, he was able to walk, and his insomnia and anxiety decreased. He remained stable with the prescribed medication until, due to complications secondary to his oncological pathology, he was admitted to The Palliative Care Unit to begin sedation.

Conclusions:

In terminal cancer patients with depression, it would be advisable to use Vortioxetine to improve their quality of life in situation of last days.