Pharmacotherapeutic Management of Depression in Patients With Cancer: A Review of Mechanistic and Clinical Evidence.
Cancer reports (Hoboken, N.J.) May 1, 2026 Sepideh Hajivalizadeh, Kimia Farahmand, Kimia Kazemzadeh et al.
Depression commonly accompanies cancer, but standard antidepressants often work poorly. This review argues that cancer-related depression has distinct biological causes—including inflammation, stress hormone dysregulation, disrupted serotonin pathways, and glutamate toxicity—and that treatments should target those mechanisms. Early evidence suggests that anti-inflammatory drugs like celecoxib, glutamate modulators like ketamine, and atypical antidepressants such as mirtazapine may be more effective than conventional SSRIs or tricyclics, which have shown inconsistent results. The review calls for a personalized, mechanism-based approach rather than a one-size-fits-all model.