If one needs to take an anti-depressant , this looks like it would be a great choice.
Maybe another one of those no brainers that have low risk/ high probability of success in stopping progression to CRPC
5. ConclusionsIn conclusion, our results demonstrated that IMI treatment inhibited cell proliferation, migration,and invasion in mCRPC PC-3 cells. The suggested mechanisms of IMI in PC-3 cells include themodulation of AKT/ERK signaling and suppression of the AKT/NF-κB signaling pathway by preventingIκBαdegradation, blocking p65 phosphorylation, and regulating chemokine and cytokine production.We suggest that IMI may be a potential chemotherapeutic candidate against metastatic CRPC.
As a psychologist and prostate cancer traveller I have been curious for some time about the role of psychopharmacology in the treatment and management of PCa.
I have read a few research papers that show quite a high reduction in progression and OS with thise in antidepressants and it wasn’t specifically any one type.
It has also surprised me how little the treatment and management of mood and depression is talked about other than sharing the challenging rollercoaster of emotional and psychological experiences most (though fascinatingly not absolutely all ) we go through. There seems little or no discussion about taking medication for this, only often in relation to manage side effects such as hot flushes.
Have I missed these threads and discussions ? I suspect the health professionals we come into contact with are quite técnicas and deeeply immersed in the physical and not trained or particularly good at the psychological or psychiatric management of PCa. Odd as blocking one of the major hormones in the body is dramatically altering central control and regulation system of not just the physiology of our physical bodies but our brain function and psychology. We all know this but seems not much is said apart from acknowledgment of it as a side effect.
I know that I generally recommend that people at least talk with a therapist, and one of the things I am about in my groups is the emotional mood of my fellow members. Certainly it has not been an easy journey for me!
yes - but uf you do a deep dive most of the studies are quite heterogeneous and usually meta analyses . Also which DFS seems to indicate depression/anxiety dies reduce the time to this OS seems less impacted. Also which the researchers around imipramine seem to want to identity a specific bio pathway to offer a causal relationship- it seems to me it may be a correlation only at the stage.
If you look at the studies they have used both SSRIs and SNRIs and imipramine is a tricyclic antidepressant. So perhaps the mechanism is about the impact of anxiety itself (increased cortisol and stress hormones etc) rather than the particular agent used.
There are lab and mice studies showing sertraline and other SSRIs inhibiting growth of prostate cancer (cells). There are observational studies, with their risk of confounders, showing association between sertraline / SSRI use and substantially reduced risk of prostate cancer. I would bet on sertraline, with less sides than imipramine.
indeed tricyclics have more side effects and sertraline is usually well tolerated though impotence and sleep can be a problem for some which might impact those of us on HT - I’m always a little suspicious of ‘mice’ or in vitro extrapolating to the human clinical environment as it so much more complex and multi factorial - not to mention the actual biological environment of the human system - of course I’m not dismissing animal studies - it’s just rarely directly transferable.
I fully agree, lab and mice studies are poorly transferable to humans. Adding the observational studies improves the odds a bit for sertraline on PCa, but they are still poor. But if you anyway want an anti-depressive, and have PCa, you just might strike it lucky with sertraline. And with imipramini too, it seems.
Here is a case study out of Switzerland about a man taking imipramine with lung cancer given 6 months to live. As of the date of this article and after a 36 month maintenance course of imipramine he was alive 6 years later.
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