Supportive Care in Cancer

, Volume 15, Issue 2, pp 123–136

The treatment of depression in cancer patients: a systematic review

  • Gary Rodin
  • Nancy Lloyd
  • Mark Katz
  • Esther Green
  • Jean A. Mackay
  • Rebecca K. S. Wong
  • Supportive Care Guidelines Group of Cancer Care Ontario Program in Evidence-based Care
Review Article

DOI: 10.1007/s00520-006-0145-3

Cite this article as:
Rodin, G., Lloyd, N., Katz, M. et al. Support Care Cancer (2007) 15: 123. doi:10.1007/s00520-006-0145-3

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.

Keywords

Systematic review Depression Treatment Cancer 

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Gary Rodin
    • 1
  • Nancy Lloyd
    • 3
  • Mark Katz
    • 2
  • Esther Green
    • 4
  • Jean A. Mackay
    • 3
  • Rebecca K. S. Wong
    • 5
  • Supportive Care Guidelines Group of Cancer Care Ontario Program in Evidence-based Care
  1. 1.Department of Psychosocial Oncology and Palliative CarePrincess Margaret HospitalTorontoCanada
  2. 2.Southlake Regional Health CentreNewmarketCanada
  3. 3.McMaster University/Cancer Care Ontario Program in Evidence-based CareHamiltonCanada
  4. 4.Cancer Care OntarioTorontoCanada
  5. 5.Department of Radiation OncologyPrincess Margaret HospitalTorontoCanada