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The treatment of depression in cancer patients: a systematic review

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Abstract

Goals of the work:

To evaluate the efficacy of pharmacological and nonpharmacological treatments for depression in cancer populations.

Materials and methods:

The Supportive Care Guidelines Group conducted a systematic review of the published literature through June 2005. Search sources includes MEDLINE, EMBASE, CINAHL, PsycInfo, and the Cochrane Library. Comparative studies of treatments for depression in cancer patients were selected for review by two group members based on predefined criteria.

Main results:

Seven trials of pharmacological agents and four of nonpharmacological interventions were identified. Two trials detected a significant reduction in depressive symptoms for mianserin compared with placebo, and one trial found alprazolam to be superior to progressive muscle relaxation. Four drug trials found no significant difference between groups on depression measures although posttreatment reduction of symptoms was observed for all groups in two trials comparing active treatments (fluoxetine vs desipramine and paroxetine vs amitriptyline). Of the four trials involving nonpharmacological therapies for the management of depression, two detected a benefit for treatment (a multicomponent nurse delivered intervention and an orientation program) over usual care.

Conclusion:

There is limited evidence for the effectiveness of pharmacological and psychosocial interventions in the treatment of cancer patients with depressive disorders, and no evidence for the superiority of one treatment modality over another. Based on evidence from the general population and other medically ill populations, combined approaches to the treatment of depression may be the most effective. Further research is necessary in cancer patients to determine the relative effectiveness of psychosocial, pharmacological, and combined treatments.

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Acknowledgements

The PEBC is supported by but editorially independent of Cancer Care Ontario and the Ontario Ministry of Health and Long-Term Care. No potential conflicts of interest with regard to this review were declared by members of the Supportive Care Guidelines Group.

Author information

Authors and Affiliations

  1. Department of Psychosocial Oncology and Palliative Care, Princess Margaret Hospital, 610 University Avenue, Toronto, ON, M5G 2M9, Canada

    Gary Rodin

  2. Southlake Regional Health Centre, 596 Davis Drive, Newmarket, ON, L3Y 2P9, Canada

    Mark Katz

  3. McMaster University/Cancer Care Ontario Program in Evidence-based Care, 1280 Main Street West, DTC, 3rd Floor, Hamilton, ON, L8S 4L8, Canada

    Nancy Lloyd & Jean A. Mackay

  4. Cancer Care Ontario, 620 University Avenue, Toronto, ON, M5G 2L7, Canada

    Esther Green

  5. Department of Radiation Oncology, Princess Margaret Hospital, 610 University Avenue, Toronto, ON, M5G 2M9, Canada

    Rebecca K. S. Wong

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  1. Gary Rodin
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  2. Nancy Lloyd
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  4. Esther Green
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Supportive Care Guidelines Group of Cancer Care Ontario Program in Evidence-based Care

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Correspondence to Gary Rodin.

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A complete list of Supportive Care Guidelines Group members is available at: http://www.cancercare.on.ca/.

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Rodin, G., Lloyd, N., Katz, M. et al. The treatment of depression in cancer patients: a systematic review. Support Care Cancer 15, 123–136 (2007). https://doi.org/10.1007/s00520-006-0145-3

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  • DOI: https://doi.org/10.1007/s00520-006-0145-3

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