The approach to treatment of depression depends on the patient’s life expectancy ([
109], also see [
110,
111]). If the patient’s life expectancy is 4–6 weeks or longer, then serotonin reuptake inhibitor
(SSRI) antidepressants (e.g., escitalopram, citalopram, sertraline, fluoxetine, paroxetine, mirtazapine ([
112,
113], also see [
114]) are the medication of choice and the best practices benchmarks for effective treatment ([
115], also see [
4,
7,
18,
23,
25,
53,
73]). For end-stage cancer patients, these medications are relatively safe, inexpensive, and useful with co-morbid conditions like anxiety and irritability; they also serve as possible analgesic synergists ([
116], also see [
13,
18,
19]). One downside is that they take 4–6 weeks or more to titrate to a normal response dose to achieve a beneficial effect ([
117,
118], also see [
7,
13,
18,
19,
23,
114]). Reports have suggested that they have some side-effects (e.g., restlessness, agitation, insomnia, sedation, parkinsonianism) that can be problematic with end-stage cancer patients, especially with co-morbid delirium [
7,
23]. On the other hand, compared to other classes of antidepressants, they have few interactions with other drugs [
7,
13,
18,
19,
23,
119], which is an important consideration with end-stage cancer patients ([
117,
118,
120], cf. [
72], also see [
21]). (Note: Kiener, Weixler, Massel, Gartner, et al. [
121] revealed that end-stage cancer patients were taking an average of 4–6 different prescription medications and up to 11 at the point of death.)