Anxiety and depression are common in patients with cancer and in palliative care settings. These symptoms can be reactive to the illness or can be related to the direct physiologic effects of the disease or to drug therapies. Effective treatment of these symptoms includes both psychopharmacologic and psychotherapeutic approaches. The newer antidepressants, anxiolytics, and hypnotics are better tolerated and can be continued safely if necessary, or they can be reduced and discontinued as symptoms improve.