Navigation Links
Researchers conduct comprehensive review of treatments for depression in cancer patients
Date:6/26/2014

Depression is common in cancer, up to half of all patients facing the disease experience depressive symptoms, ranging from mild to severe. When depression co-exists with cancer, patients may be at an increased risk of death from cancer and from suicide.

Antidepressants are commonly prescribed, but the evidence on their efficacy is mixed. The role of antidepressants in treating cancer-related depression has not been rigorously studied. To identify best practice for the treatment of depression in cancer, Dartmouth researchers completed a systematic review and meta-analysis of existing research. The paper was published in General Hospital Psychiatry in June.

The review identified two classes of antidepressants that reduce symptoms of depression:

  • An alpha-2-adrenergic receptor antagonist: Mianserin
  • Two selective serotonin reuptake inhibitors: fluoxetine (Prozac) and paroxetine (Paxil)

Available evidence suggests that paroxetine and fluoxetine can improve depressive symptoms but may be less well-tolerated.

Miaserin also showed a higher depression response rate compared to placebo, whereas paroxetine and fluoxetine did not. The response rates were low suggesting only modest changes in depressive symptoms.

"All the evidence for alpha-2-andrenergic receptors was based on a single agent, Mianserin," said Natalie Riblet, MD, MPH, lead author of the study, Department of Psychiatry, Geisel School of Medicine. "Unfortunately, the most promising agent, Mianserin, is not available in the US. Given that Mirtazapine is a close pharmacological cousin of Mianserin, there may be clinical benefit to further exploring the role of Mirtazapine in the management of cancer-related depression."

In terms of side effect profiles, Mianserin appeared slightly more tolerable compared to placebo; paroxetine had slightly higher but nonsignificant dropout rate due to side effects compared to placebo; fluoxetine had a significantly higher dropout than placebo, though this finding became non-significant after removing a study outlier.

"Adverse drug interactions are possible between chemotherapy agents and antidepressants," said Riblet. "Specifically tamoxifen, a common chemotherapy agent, may interact with certain antidepressants to increase risk of serious side effects."

The different classes of antidepressants work on different neurotransmitters. The study reported that the alpha-2-andrenergic receptor antagonists show particular promise in cancer patients possibly due to their pharmacological profile, which increases norepinephrine and serotonin. Alpha-2-andrenergic receptor antagonists are less likely to cause common serotonin-related side effects such as headache, agitation, jitteriness, or sexual dysfunction, but may contribute to sedation.

The review included nine randomized trials conducted between 1985 and 2011 with 4,700 eligible records from 1,169 patients from various countries. Overall 83 percent of subjects were female with a mean age of 54 years.

"There is a scarcity of evidence to address the role of antidepressants in cancer-related depression," said Riblet. "Our findings suggest there is a need for high-quality randomized clinical trials that explore the role of antidepressants in treating cancer-related depression."


'/>"/>

Contact: Robin Dutcher
Robin.Dutcher@hitchcock.org
603-653-9056
The Geisel School of Medicine at Dartmouth
Source:Eurekalert

Related medicine news :

1. Miriam Hospital researchers develop app focused on making obese adults less sedentary
2. Researchers home in on way to predict aggressiveness of oral cancer
3. Researchers call for patients who receive home nutritional care to have emergency plans
4. Chronic brain damage not as prevalent in NFL players, say researchers
5. Researchers treat incarceration as a disease epidemic, discover small changes help
6. Researchers publish one of the longest longitudinal studies of cognition in MS
7. SLU researchers see possible answer to chemo pain in a multiple sclerosis drug
8. Miriam Hospital researchers analyze AUDs, sexual behavior among South African men
9. Researchers find gene critical for development of brain motor center
10. New target: Researchers identify pancreatic cancer resistance mechanism
11. U of MD researchers receive NIH grant to study personalized medicine for genetic diabetes
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/25/2016)... ... 25, 2016 , ... As a lifelong Southern Californian, Dr. Omkar Marathe earned ... the David Geffen School of Medicine at UCLA. He trained in Internal Medicine at ... fellowship in hematology/oncology at the UCLA-Olive View-Cedars Sinai program where he had the opportunity ...
(Date:6/24/2016)... ... June 24, 2016 , ... A recent article published June ... with. The article goes on to state that individuals are now more comfortable seeking ... common operations such as calf and cheek reduction. The Los Angeles area medical group, ...
(Date:6/24/2016)... Dallas, Texas (PRWEB) , ... June 24, 2016 ... ... 12th International Conference and Scientific Sessions in Dallas that it will receive two ... Announcement of the grants came as PHA marked its 25th anniversary by recognizing ...
(Date:6/24/2016)... ... 24, 2016 , ... Topical BioMedics, Inc, makers of Topricin and MyPainAway Pain Relief Products, join ... wage raise to $12 an hour by 2020 and then adjusting it yearly to increase ... of the minimum wage, assure the wage floor does not erode again, and make future ...
(Date:6/24/2016)... , ... June 24, 2016 , ... ... The Grove Investment Group (TGIG), has initiated cultivation and processing operations at its ... Vegas and Pahrump, Nevada. , Puradigm is the manufacturer of a complete system ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... Research and Markets has announced the addition of ... report to their offering. ... The World Market for Companion Diagnostics covers the world market ... the report includes the following: , World ... Region (N. America, EU, ROW), 2015-2020 , World IVD ...
(Date:6/24/2016)... LEXINGTON, Mass. , June 24, 2016   ... specialty pharmaceutical company developing innovative inhaled drugs, announced today ... when Russell Investments reconstituted its comprehensive set ... 2016. "This is an important milestone for ... "It will increase shareholder awareness of our progress in ...
(Date:6/24/2016)... 24, 2016  Arkis BioSciences, a leading innovator ... more durable cerebrospinal fluid treatments, today announced it ... funding is led by Innova Memphis, followed by ... private investors.  Arkis, new financing will accelerate the ... market release of its in-licensed Endexo® technology. ...
Breaking Medicine Technology: