IMPORTANT UPDATE:   New study reported at ASCO shows increased risk of relapse for breast cancer survivors taking certain antidepressants.  See the new article here.  I urge every survivor taking antidepressants to read the article and the original study and discuss it with your doctor.

The timing of this research is welcome: down at the American Society of Clinical Oncologists meeting, a researcher is promoting Paxil as a treatment for chemo brain simply on the basis of a single study involving a memory test.

It is very important not to "over-medicate" cancer patients, because the drug interactions can be impossible to manage. As a former cancer patient (Stage III BC), I often wondered if asking for a psychoactive drug wasn't viewed by medical staff as a sick child asking for a pixie stick.

Previously:

I've been up early this morning reading some discussion boards on the American Cancer Society's Cancer Survivor Network.  Many, mostly women, are suffering from "losing" their minds, mental fog, and depression.  My heart cries out for everyone who has done "all the right things" in cancer treatment-- following their oncologist's regimen of treatment and adjuvant medications.   At the end of chemo, many begin to report depression.

Depression can be and usually is both psychological in origin as well as physiological.  From the psychological perspective, feelings of helplessness or disempowerment are often associated with ( i.e., can cause) depression.  I do believe that this is part of the issue following treatment.  The feeling that "I am doing something about this disease" derived from following a treatment plan, as well as the emotional support from the infusion, radiation, and lab staff, can produce positive emotions.   When chemo and/or radiation cease, this happens much less frequently.

At the same time, the chemotherapy's damaging effect on the brain cells is becoming apparent. This, plus diet and exercise changes, affects the physiological (chemical) activity.  

Any or both can lead to depression symptoms.  Please let me be technical for a moment, and differentiate depression symptoms from the disorder called depression.  Most people do have episodes of depression, and the symptoms of depression reported by cancer patients should not be minimized.  On the other hand, I don't want patients to believe that they now have another disorder and must now take antidepressants for the rest of their lives.

I'm concerned about  adding more chemicals into an already chemically-damaged brain.  If someone has acute symptoms, medications may help in the short run, but I advise that patients be in the care of a psychiatrist who is expert in how these medications affect the brain and can help with finding the right medication.

For the most part, I advise using antidepressants as a last resort, and the reason is because of my practice.

I often perform neurofeedback services, and also research the effects of various medications on brain performance. For many of the individuals, even those not on chemo, the antidepressants are associated with increased slow wave and/or decrease faster or alert waves.  I also see this  during allergy season, and even after dental anesthesia.   When slow waves dominate, such as just before sleep, the mind feels slow, groggy, and unable to focus.  Faster waves are associated with increased alertness, and very fast waves can be associated with anxiety.

If you are experiencing mental fog from chemo, antidepressants could worsen the situation.

Specific foods and exercise can help with mood and restoring brain function.  The Omega-3 fatty acids in particular help with cell communications; many of my clients experience elevated mood within days of starting supplementation or dietary changes. 

Exercise, even brisk walking, increases oxygen flow and can activate those pleasure sites in the brain.

This blog is not intended to replace the advice of a health care professional.