NEUROBIOCHEMICAL CHANGES FROM TAXOL NEUPOGEN CHEMOTHERAPY FOR METASTATIC BREAST-CARCINOMA CORRESPONDS WITH SUICIDAL DEPRESSION/

A patient under Taxol and granulocyte colony stimulating factor (G-CSF , Neupogen) treatment for metastatic breast carcinoma of the liver exp erienced repeated suicidal depression on days 10 and 11 of therapy. MR I and MRS were performed during the fifth and sixth cycles of chemothe rapy on days 1 and 10. The MRI was normal in all four examinations. Th e MRS showed normal levels of metabolites on days 1 of therapy, with r emarkable reproducible declines in neurobiochemicals myoinositol (23-2 7%), choline (20-24%), creatine (10-14%) and glutamate/glutamine (22-3 9%) on day 10 of therapy. The neurobiochemical declines coincided with the patient's experience of suicidal depression. Patients reporting d epression during standard cancer therapy may be experiencing previousl y undocumented chemotherapeutic neurobiochemical imbalances or neuroto xicity.