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Table 1 Overview of the reviewed studies

From: Antidepressants in the treatment of depression/depressive symptoms in cancer patients: a systematic review and meta-analysis

Author

Year

Drug

Study design

Participants (n)

Duration

Type of cancer/Stages

Evaluation

Results

A. Head-to-head trials

Holland

1998

Fluoxetine vs. Desipramine

Double blind RCT, ITT analysis, LOCF approach

n= 38

6 weeks

Breast cancer, Stages II, III, IV

HDRS Other: CGI, PGI, HAS, FLIC, MPAC, SF-36 HS

No significant difference between fluoxetine and desipramine.

Pezella

2001

Paroxetine vs. Amitriptyline

Double blind RCT, ITT analysis, LOCF approach

n= 179 177 received medication

8 weeks

Breast cancer, any stage

MADRS Other: CGI, FLIC, PGE

38/88 subjects in the drug group and 33/87 in the amitryptiline group were responders (p= 0.441)

Cancurtaran

2008

Mirtazapine vs. Imipramine vs. Control groupwithout medication

Double blind (for the participants of the two drug groups) RCT, completers’ analysis

n= 53

6 weeks

NR

SCID, HADS

Significant improvement in the mirtazapine group. No significant change in the other two groups.

B. Placebo controlled studies

Costa

1985

Mianserin

Double blind RCT, ITT analysis, LOCF approach

n= 73

4 weeks

Gynecological cancer, stages II, III, IV

ZSDRS, HDRS, CGI-S

28/36 in the Mianserin group and 18/37 in the placebo group were responders (p< 0.025).

Van Heeringen

1996

Mianserin

Double blind RCT, ITT analysis, LOCF approach

n= 55

7 weeks

Breast cancer, stages I, II

HDRS

19/28 patients in the mianserin group and 10/27 in the placebo group were responders (p= 0.044).

Razavi

1996

Fluoxetine

Double blind RCT, completers’ analysis

n= 91

5 weeks

Any kind of cancer, any stage

HADS Other: MADRS, HAS, SCL-90R, SQOLI

18% in the fluoxetine group and 20% in the placebo group were responders (no significant difference)

Fisch

2003

Fluoxetine

Double blind RCT, Completers’ analysis

n= 163

12 weeks

Any type of cancer, advanced stage

TQSS, FACT-G, BZRDS

Results available for 129 patients. 31/64 patients in the fluoxetine group and 23/65 in the placebo group were responders (p= 0.12).

Musselmann

2006

Paroxetine vs Desipramine vs placebo

Double blind RCT, ITT analysis, LOCF approach

n= 35

6 weeks

Breast cancer, any stage

DSM-III-R- multiaxial evaluation HAD, HAS, CGI

5/13 in the paroxetine group, 5/11 in the desipramine group and 6/11 in the placebo group were responders (no statistical significance).

Navari

2007

Fluoxetine

Double blind RCT, completers’ analysis

n= 193

Six months

Breast cancer, stages I, II

TQSS, BZDRS, FACT-G

71/90 subjects in the fluoxetine group and 23/90 in the placebo group showed a significant (p< 0.01) improvement (p< 0.0005).

  1. BZDRS: Brief Zung depression rating scale, CGI-S: Clinical global impression Scale for Severity of Illness, DSM: Diagnostic and statistical manual for mental disorders, FACT-G: Functional assessment of cancer therapy- global, FLIC: Functional living index- cancer, HAD: Hamilton Depression Scale, HADS: Hospital anxiety and depression scale, HAS: Hamilton anxiety scale, HDRS: Hamilton rating depression scale, ITT: Intention-to-treat, LOCF: last observation carried forward, MADRS: Montgomery and Asberg depression rating scale, MPAC: Memorial pain assessment card, NR: Not reported, PGE: Patients’ global evaluation, PGI: Patients’ global impression, RCT: Randomized controlled trial, SCID: Structured clinical interview for DSM, SF36-HS: Short Form 36 Health survey, SCL-90-R: Symptom Checklist 90, Revised, SQOLI: Spitzer Quality of Life Index, TQSS: Two questions screening survey, ZSRDS: Zung self-rating depression scale.