{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T09:38:42Z","timestamp":1793871522421,"version":"4.6.1"},"reference-count":12,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2023,6,6]],"date-time":"2023-06-06T00:00:00Z","timestamp":1686009600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Oncol Pharm Pract"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Tyrosine kinase inhibitor (TKI) use leads to near-normal life expectancy in patients with chronic myeloid leukemia (CML); unfortunately for some patients, adverse drug effects (ADEs) and medication burden associated with TKI therapy can lead to decreased quality of life. Additionally, TKIs have drug interactions that may negatively impact patients\u2019 management of co-morbidities or lead to increased ADEs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case report<\/jats:title>\n                    <jats:p>A 65-year-old female with a history of anxiety treated and controlled with venlafaxine experienced increased and resistant anxiety and insomnia after starting dasatinib for CML.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Management and outcome<\/jats:title>\n                    <jats:p>On dasatinib, the patient experienced worsening anxiety and insomnia. The stress of a new leukemia diagnosis, drug interactions, and ADEs from dasatinib were considered possible causes. Dose adjustments to dasatinib and venlafaxine were made to control the patient\u2019s symptoms. However, the patient\u2019s symptoms did not resolve. After being on dasatinib for 2.5 years, the patient discontinued TKI therapy due to being in a deep molecular remission and given ongoing challenges managing anxiety. Within 4 months of stopping dasatinib, the patient reported an improvement in anxiety and overall emotional wellbeing. She continues to feel better and remains in a complete molecular remission 20 months off treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This case demonstrates a possible previously unknown drug interaction with dasatinib as well as a possible rarely reported ADE of dasatinib. Additionally, it highlights the difficulties patients with psychiatric disorders may face on TKI therapy and challenges providers may have in identifying rare psychiatric ADEs, thus emphasizing the need for documentation of these types of cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10781552231181333","type":"journal-article","created":{"date-parts":[[2023,6,7]],"date-time":"2023-06-07T02:19:37Z","timestamp":1686104377000},"page":"1762-1765","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Anxiety exacerbation in a patient with chronic myeloid leukemia receiving dasatinib and venlafaxine"],"prefix":"10.1177","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5230-4087","authenticated-orcid":false,"given":"Christopher","family":"Bell","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Massachusetts General Hospital, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2881-3452","authenticated-orcid":false,"given":"Jessie","family":"Signorelli","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Massachusetts General Hospital, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela","family":"Hobbs","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,6,6]]},"reference":[{"key":"bibr1-10781552231181333","unstructured":"National Comprehensive Cancer Network (NCCN)\n                      . Chronic Myeloid Leukemia v1.2023, www.nccn.org\/professionals\/physician_gls\/pdf\/cml.pdf (2022, accessed 15 December 2022)."},{"key":"bibr2-10781552231181333","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199907153410306"},{"key":"bibr3-10781552231181333","doi-asserted-by":"publisher","DOI":"10.1080\/10428194.2020.1842397"},{"key":"bibr4-10781552231181333","doi-asserted-by":"publisher","DOI":"10.1111\/fcp.12544"},{"key":"bibr5-10781552231181333","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-012-1630-5"},{"key":"bibr6-10781552231181333","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-018-3413-7"},{"key":"bibr7-10781552231181333","volume-title":"Imatinib (package insert)","author":"Novartis Pharmaceuticals Corporation","year":"2022"},{"key":"bibr8-10781552231181333","volume-title":"Nilotinib (package insert)","author":"Novartis Pharmaceuticals Corporation","year":"2021"},{"key":"bibr9-10781552231181333","volume-title":"Dasatinib (package insert)","author":"Bristol-Myers Squibb Company","year":"2021"},{"key":"bibr10-10781552231181333","volume":"2014","author":"Sami MB","journal-title":"BMJ Case Rep"},{"key":"bibr11-10781552231181333","volume-title":"Venlafaxine (package insert)","author":"Pfizer Inc","year":"2022"},{"key":"bibr12-10781552231181333","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.1981.154"}],"container-title":["Journal of Oncology Pharmacy Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10781552231181333","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10781552231181333","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10781552231181333","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T02:28:38Z","timestamp":1777688918000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10781552231181333"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,6]]},"references-count":12,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2023,10]]}},"alternative-id":["10.1177\/10781552231181333"],"URL":"https:\/\/doi.org\/10.1177\/10781552231181333","relation":{},"ISSN":["1078-1552","1477-092X"],"issn-type":[{"value":"1078-1552","type":"print"},{"value":"1477-092X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,6]]}}}