Pharmacokinetics and pharmacodynamics of mood altering drugs in patients with cancer

Undertreatment of depression in patients with cancer is a clinical problem requiring prompt action. Although responsive to cognitive and behavioral interventions, unipolar depression in patients with cancer often requires pharmacologic management. Because of pathologies associated with cancer and its treatment, pharmacologic outcomes are often unpredictable, necessitating careful assessment of risk factors for over- and undermedication. This article reviews important principles of pharmacokinetics and pharmacodynamics of mood-altering drugs administered by oral routes and ways therapeutic effects might be influenced by cancer. Contingent implications for advancing practice, research, and policy are also described.