fluvoxamine and Neoplasms

Topics: Alzheimer Disease; Animals; COVID-19; COVID-19 Drug Treatment; Drug Repositioning; Fluvoxamine; Humans; Mental Disorders; Neoplasms; Post-Acute COVID-19 Syndrome; Psychotropic Drugs; Selective Serotonin Reuptake Inhibitors

To observe treatment effects and safety of fluvoxamine combined with oxycodone prolonged-release tablets in treating patients with moderate to severe cancer pain.. Patients confirmed pathologically with cancer and complicated with moderate to severe pain, were divided into control and experimental groups. Oxycodone prolonged-release tablets, with or without fluvoxamine, were administrated to all study patients until pain relief. Degree of pain relief, dose of oxycodone prolonged-release tablets, side effects and quality of life were compared before and after treatment.. In total, 120 patients were recruited. No statistically significant difference was detected regarding age, gender, types of cancer, KPS between two groups of patients (P> 0.05). Baseline pain score of patients with moderate pain in treatment and control group was 4.9±0.8 and 5.1±0.8, respectively; and decreased to 1.8±1.1 and 1.2±1.1 after treatment, respectively. Pain intensity was significantly reduced in the treatment group (P =0.028). Average daily consumption of oxycodone prolonged- release tablets was (54.0±19.6) mg and (44.7± 18.7) mg respectively, which is lower in treatment grpup than in control group, but the difference was not statistically significant (P=0.065). Baseline pain score of patients with severe pain in treatment and control groups were 8.3±1.1 and 8.3±1.1, respectively; and pain intensity after treatment decreased to 2.9±1.0 and 2.3±1.0. Pain intensity was significantly reduced in the treatment group, with statistical significance (P =0.026). Average daily consumption of oxycodone prolonged-release tablets was (132.0±42.2) mg and (110.7±33.9) mg, respectively, which is lower in treatment group than in control group, and the difference was statistically significant (P=0.035). In terms of quality of life, patients in treatment group had better performance status, daily activity, mood, and sleep than that in control group (P < 0.05). Patients in two groups had similar side effects, eg., constipation, nausea/vomiting, lethargy, dizziness, itchy skin, dysuria, and ataxia. Lower incidence of nausea/vomiting, lethargy, was obtained from patients in treatment than in control group, while significant low constipation was observed in treatment than in control group (35.0% vs 49.2%, P=0.026).. Fluvoxamine combined with oxycodone prolonged-release tablets could be more effective in treating patients with cancer pain, and could reduce the dosage of oxycodone prolonged-release tablets and thus be associated with lower side effects, and improved quality of life.

Topics: Analgesics, Opioid; Delayed-Action Preparations; Drug Therapy, Combination; Female; Fluvoxamine; Humans; Male; Neoplasms; Oxycodone; Pain; Pain Measurement; Quality of Life; Selective Serotonin Reuptake Inhibitors; Treatment Outcome

To evaluate the safety, tolerability, and benefit of fluvoxamine for the treatment of major depressive disorder or anxiety disorders in children and adolescents with cancer.. The study was conducted from 2001 to 2004 at a pediatric hematology-oncology center. Fifteen children and adolescents with cancer were treated with fluvoxamine 100 mg/day in an open prospective 8-week trial. Safety and tolerability were evaluated at baseline and at weeks 4 and 8 by blood tests and the Side Effects Checklist. Clinical benefit was assessed with the Clinical Global Impressions-Improvement, the Children's Depression Rating Scale-Revised, and the Pediatric Anxiety Rating Scale.. Fluvoxamine was well tolerated by all subjects. Psychiatric symptoms improved significantly.. In this open trial, fluvoxamine appeared to be well tolerated and was associated with a promising reduction in the depression and anxiety symptoms of pediatric patients with cancer.

Topics: Adolescent; Anti-Anxiety Agents; Antidepressive Agents, Second-Generation; Anxiety Disorders; Child; Depressive Disorder, Major; Fluvoxamine; Follow-Up Studies; Humans; Neoplasms; Pilot Projects; Selective Serotonin Reuptake Inhibitors; Sick Role

Patients prescribed antiplatelet treatment to prevent recurrent acute myocardial infarction are often also given a selective serotonin reuptake inhibitor (SSRI) to treat coexisting depression. Use of either treatment may increase the risk of bleeding. We assessed the risk of bleeding among patients taking both medications following acute myocardial infarction.. We conducted a retrospective cohort study using hospital discharge abstracts, physician billing information, medication reimbursement claims and demographic data from provincial health services administrative databases. We included patients 50 years of age or older who were discharged from hospital with antiplatelet therapy following acute myocardial infarction between January 1998 and March 2007. Patients were followed until admission to hospital due to a bleeding episode, admission to hospital due to recurrent acute myocardial infarction, death or the end of the study period.. The 27,058 patients in the cohort received the following medications at discharge: acetylsalicylic acid (ASA) (n = 14,426); clopidogrel (n = 2467), ASA and clopidogrel (n = 9475); ASA and an SSRI (n = 406); ASA, clopidogrel and an SSRI (n = 239); or clopidogrel and an SSRI (n = 45). Compared with ASA use alone, the combined use of an SSRI with antiplatelet therapy was associated with an increased risk of bleeding (ASA and SSRI: hazard ratio [HR] 1.42, 95% confidence interval [CI] 1.08-1.87; ASA, clopidogrel and SSRI: HR 2.35, 95% CI 1.61-3.42). Compared with dual antiplatelet therapy alone (ASA and clopidogrel), combined use of an SSRI and dual antiplatelet therapy was associated with an increased risk of bleeding (HR 1.57, 95% CI 1.07-2.32).. Patients taking an SSRI together with ASA or dual antiplatelet therapy following acute myocardial infarction were at increased risk of bleeding.

Topics: Adrenal Cortex Hormones; Age Factors; Aged; Anemia; Angioplasty; Anticoagulants; Antihypertensive Agents; Aspirin; Canada; Citalopram; Clopidogrel; Cohort Studies; Drug Therapy, Combination; Female; Fluoxetine; Fluvoxamine; Heart Failure; Hemorrhage; Humans; Hypoglycemic Agents; Male; Middle Aged; Myocardial Infarction; Neoplasms; Paroxetine; Peptic Ulcer; Platelet Aggregation Inhibitors; Renal Insufficiency; Retrospective Studies; Risk; Risk Factors; Secondary Prevention; Selective Serotonin Reuptake Inhibitors; Sertraline; Sex Factors; Ticlopidine

In the present study, the effects of fluvoxamine on the inhibition of gastrointestinal transit, antinociception and hyperlocomotion induced by morphine were investigated in mice. Treatment with morphine (10 mg/kg, subcutaneously (s.c.)) inhibited gastrointestinal transit and hyperlocomotion. These effects were attenuated by fluvoxamine in a dose-dependent manner. On the other hand, morphine (1 mg/kg, s.c.)-induced antinociception was significantly potentiated by fluvoxamine. These results suggest that fluvoxamine combined with morphine may be useful for the treatment of not only depression but also pain in cancer patients without constipation or activation of the mesolimbic dopaminergic system. However, further understanding and clinical studies will be required to confirm this possibility.

Topics: Analgesics, Opioid; Animals; Depression; Dose-Response Relationship, Drug; Drug Interactions; Drug Therapy, Combination; Fluvoxamine; Gastrointestinal Transit; Hyperkinesis; Mice; Morphine; Neoplasms; Nociceptors; Pain, Intractable; Selective Serotonin Reuptake Inhibitors; Terminal Care; Terminally Ill

Knowing the negative effect of depression on lymphocyte number and activity in humans, we investigated the effect of antidepressant therapy on various lymphocyte subgroups. Cancer patients receiving treatment for at least 6 months were asked to take the antidepressant, fluvoxamine, for 28 days. Before and at the end of the study, physical and psychiatric examinations were performed, and the severity of depression was assessed by the Hamilton Scale for Depression (HAM-D). In addition, a sample of blood was withdrawn from the patients to quantify the following parameters: total leukocyte and lymphocyte counts, T4, T8, and Natural Killer (NK) cells, and lymphocyte response to the mitogens phytohemagglutinin (PHA) and pokeweed (PWM). Ten adult patients completed the study. Five of the 10 responded favorably to fluvoxamine treatment. Mean improvement was 50% from the score on day one. There was a significant correlation between the change in the HAM-D score of the "responders" and the change in NK cell counts (p = 0.02). The mean increment in NK cell number was 53%. In 4 of the 5 "non-responders", NK cell number dropped by 65% (mean). No correlation between the change in HAM-D score and any other immunological parameters was detected. Fluvoxamine increases NK cell counts in cancer patients, probably by its antidepressant effect.

Topics: Adult; Aged; Antidepressive Agents, Second-Generation; Depression; Female; Fluvoxamine; Humans; Killer Cells, Natural; Lymphocyte Count; Male; Middle Aged; Neoplasms; Psychological Tests; Severity of Illness Index; Treatment Outcome