Depression, Including Anxiety Disorders, Complicated Bereavement, Poor Sleep Etc

Clinical Description

• Psychological impact of advanced incurable disease
• Common causes (see relevant chapter for details)

Non-pharmacological

• Symptoms can be common in patients with advanced disease. Holistic care, including pain management and spiritual support of the patient and family caregivers can assist.

Allowing the patients to engage in activities of daily living including cooking, attending prayers etc. can reduce these symptoms.

Pharmacological

• Antidepressants (e.g. amitriptyline , fluoxetine) are rarely indicated, refer to section on depression for details of drugs
• Benzodiazepines (e.g. lorazepam and diazepam) are highly addictive, and use should be avoided

Complications and Referral Criteria

• Depending on the level of care, referral might be necessary for appropriate care