One large multicenter phase III trial found depressive symptoms in 11% of those receiving pemetrexed.133 Another multicenter study examined a regimen of pemetrexed and cisplatin and found a 14% rate of occurrence.134 Depression has been listed among the adverse reactions to fludarabine, another antimetabolite; however, this has not been reported often during controlled trials that have looked at Inhibitors,research,lifescience,medical its safety and efficacy. Furthermore, one study examining the safety of oral fludarabine

showed a statistically significant improvement in the mean scores of emotions among patients who received this agent.135 www.selleckchem.com/products/Dasatinib.html medications that interfere with DNA and RNA synthesis Doxorubicin and daunorubicin are anthracyclic antibiotics that act by binding to DNA and disordering synthesis. Based on animal models, this class of medications is potentially neurotoxic; however, at therapeutic doses in humans these agents do not cross the blood-brain barrier. Depression is not commonly associated with these Inhibitors,research,lifescience,medical agents; nevertheless, one prospective, randomized phase III trial (comparing doxorubicin and daunorubicin for the treatment of Kaposi’s sarcoma), Inhibitors,research,lifescience,medical reported the incidences of depression as 6% and 10%, respectively136 L-Asparaginase (a naturally occurring enzyme that inhibits protein, DNA,

and RNA synthesis in tumor cells by decreasing circulating levels of asparagine) has been associated with assorted psychiatric symptoms (including irritability, depression, and hallucinations). Haskell and colleagues137

reported that up to 31% of patients taking this medication developed CNS abnormalities (most commonly moderate to severe depression associated with personality Inhibitors,research,lifescience,medical disturbances). Ohnuma138 reported that 25% of patients developed mild depression and drowsiness within 1 month of therapy; higher doses were related with more severe symptoms, and discontinuation of it led to the resolution of symptoms.139 Mitotic inhibitors Taxane drugs (ie, paclitaxel and docetaxel) Inhibitors,research,lifescience,medical are mitotic inhibitors that interfere with the normal breakdown of microtubules during cell division. Several studies have found an association between these medications and depressive symptoms. One case report of a woman receiving paclitaxel described the onset of severe depression and suicidal thoughts that remitted following the discontinuation of the drug.140 In a prospective RCT, Fountzilas and associates141 reported worse emotional function in those Entinostat receiving paclitaxel as part of a multidrug regimen as compared with those receiving the same regimen without paclitaxel. Finally, in a naturalistic, longitudinal study, Thornton and coworkers142 documented slower psychological recovery and higher rates of depressive symptoms in patients receiving paclitaxel and docetaxel. Biological agents Interleukins Interleukin-2 (IL-2) has been used in the treatment of metastatic renal cancer, melanoma, and other malignancies.