유방암 환자에서 항우울제의 사용

Use of Antidepressants in Patients with Breast Cancer

Depression is common among patients with breast cancer and has been found to influence quality of life and disease course as well as to increase fatigue, pain, and insomnia. Therefore, it is very important to treat depression among breast cancer patients with antidepressants in order to improve clinical outcomes. However, inconsistent results about the consequences of antidepressant use in patients with breast cancer have been reported. This article reviews and discusses the following issues：epidemiologic data about depression in patients with breast cancer; debates about the association between antidepressant use and breast cancer risk；pharmacological interactions of antidepressants and medications for breast cancer, including tamoxifen and opioids；data from clinical trials addressing the effect of antidepressants on depressive symptoms in patients with breast cancer; and data from clinical trials addressing the effect of antidepressants on cancer-related symptoms, including hot flashes, post-mastectomy pain syndrome, nausea, pruritus, fatigue, and sexual dysfunction. This review article contributes to a comprehensive understanding of the use of antidepressants in patients with breast cancer. (Korean J Psychopharmacol 2009;20(2):63-77)