Antidepressants appear safe in patients with carcinoid tumor: Results of a retrospective review Journal Article

Authors: Isenberg-Grzeda, E.; MacGregor, M.; Bergel, A.; Eagle, S.; Espi Forcen, F.; Mehta, R.; Matsoukas, K.; Wills, J.; Reidy-Lagunes, D.; Alici, Y.
Article Title: Antidepressants appear safe in patients with carcinoid tumor: Results of a retrospective review
Abstract: Introduction: Patients living with neuroendocrine tumors have high rates of depression, often necessitating antidepressants, including selective serotonin reuptake inhibitors (SSRI). Neuroendocrine tumors (NETs) secrete vasoactive substances, including serotonin, which contribute to the cluster of symptoms known as carcinoid syndrome (flushing and diarrhea). Controversy exists over whether or not antidepressants are safe in NET. We aimed to study the safety of antidepressant use in NET patients. Methods: We conducted a retrospective chart review of patients with well differentiated NET who were also prescribed antidepressants from January 2008 through April 2015. The study took place at Memorial Sloan Kettering Cancer Center and was approved by the hospital's institutional review board. Results: Ninety-two patients were included. There were 16 (17.4%) patients with carcinoid syndrome (10 ileum, 1 duodenum, 1 jejunum and 4 unknown primary); and 76 (82.6%) patients without (41 lung, 9 pancreas, 8 ileal, 5 duodenum, 5 appendix, 2 unknown primary, 1 jejunum and 5 other). Median duration of antidepressant prescription was 11.6 months (range, 0–121) among those with carcinoid syndrome (N = 16) and 14.3 months (range, 0–172) among those without carcinoid syndrome (n = 76). Antidepressants were stopped in 31 cases (33.7%), though the reason was not specified in the majority of cases (n = 18; 58%). None of the patients developed carcinoid syndrome while being prescribed antidepressants. No patients developed carcinoid crisis. Conclusion: Our findings do not support previous authors’ recommendations that SSRIs must be avoided in NET patients. Several classes of antidepressants appeared safe in NET patients with and without carcinoid syndrome. © 2018 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology
Keywords: depression; neuroendocrine tumors; serotonin; antidepressive agents; serotonin uptake inhibitors; malignant carcinoid syndrome
Journal Title: European Journal of Surgical Oncology
Volume: 44
Issue: 6
ISSN: 0748-7983
Publisher: Elsevier Inc.  
Date Published: 2018-06-01
Start Page: 744
End Page: 749
Language: English
DOI: 10.1016/j.ejso.2018.03.010
PROVIDER: scopus
PMCID: PMC5970966
PUBMED: 29622373
Notes: Article -- Export Date: 2 July 2018 -- Source: Scopus
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MSK Authors
  1. Yesne Alici
    43 Alici
  2. Diane Lauren Reidy
    149 Reidy
  3. Jonathan   Wills
    21 Wills