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Sertraline effectiveness and safety in depressed oncological patients

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Abstract

Goals of work

Cancer is often burdened by psychological comorbidity, mainly represented by depression, anxiety and adjustment disorders. Efficacy and tolerability of sertraline in the treatment of depressive disorders is well known; however, its efficacy and safety in patients with cancer has been poorly studied. This study was aimed to provide evidences of effectiveness, safety, tolerability and rapidity of action of sertraline in a population of oncological outpatients affected by mood disorders and its effects on quality of life.

Materials and methods

Thirty-five adult cancer outpatients with mood depression, during chemotherapy, were enrolled to a 12-week trial with a flexible dose regime of sertraline. The treatment response was assessed at baseline, week 4 and week 12, with hospital anxiety and depression scale (HADS) and Montgomery Asberg depression rating scale (MADRS), to rate depression and anxiety; mini mental adjustment to cancer scale (Mini-MAC), to assess the psychological response to the diagnosis of cancer; clinical global impression (CGI) to evaluate severity of illness; dosage record and treatment emergent symptom scale (DOTES), to assess the adverse effects of the clinical treatments and their possible relation with the drug used; and QL index to rate quality of life.

Main results

Both mean depression scores, analysed by HADS and MADRS scales, and HADS anxiety scores significantly decreased during the 12 weeks of study. Mean MINI-MAC scores show that hopelessness and anxious preoccupation decreased significantly at T2 compared with T0. No severe adverse effects were observed.

Conclusion

In this preliminary study, sertraline was found to be effective and well tolerated in the treatment of depressed outpatients with cancer.

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References

  1. American Psychiatry Association (2000) DSM-IV-TR: diagnostic and statistical manual of mental disorders, text revision, 4th edn. American Psychiatry Association, Washington, DC

    Google Scholar 

  2. Ashbury FD, Madlensky L, Raich P et al (2003) Antidepressant prescribing in community cancer care. Support Care Cancer 11(5):278–285

    PubMed  Google Scholar 

  3. Binaschi L, Berra C, Caldera P, Torta R, Mussa A (2006) Somatic, affective and cognitive symptoms for diagnosing mood disorders in cancer patients. Psychooncology 15(S2):176–177

    Google Scholar 

  4. Black SA, Markides KS (1999) Depressive symptoms and mortality in older Mexican Americans. Ann Epidemiol 9(1):45–52

    Article  PubMed  CAS  Google Scholar 

  5. Derogatis LR, Morrow GR, Fetting J et al (1983) The prevalence of psychiatric disorders among cancer patients. JAMA 249(6):751–757

    Article  PubMed  CAS  Google Scholar 

  6. Evans DL, McCartney CF, Haggerty JJ Jr, Nemeroff CB, Golden RN, Simon JB, Quade D, Holmes V, Droba M, Mason GA et al (1988) Treatment of depression in cancer patients is associated with better life adaptation: a pilot study. Psychosom Med 50(1):73–76

    Google Scholar 

  7. Faller H, Bulzebruck H, Schilling S, Drings P, Lang H (1997) Do psychological factors modify survival of cancer patients? II: results of an empirical study with bronchial carcinoma patients. Qual Life Res 6(2):159–168 (Mar)

    Google Scholar 

  8. Fisch MJ, Loehrer PJ, Kristeller J et al (2003) Fluoxetine versus placebo in advanced cancer outpatients: a double-blinded trial of the Hoosier Oncology Group. J Clin Oncol 21(10):1937–1943

    Article  PubMed  CAS  Google Scholar 

  9. Fisch MJ (2004) Treatment of depression in cancer. J Natl Cancer Inst Monographs 32:105–111

    Article  PubMed  Google Scholar 

  10. Goodnick PJ, Hernandez M (2000) Treatment of depression in comorbid medical illness. Expert Opin Pharmacother 1(7):1367–1384

    Article  PubMed  CAS  Google Scholar 

  11. Grassi L, Rosti G (1996) Psychiatric and psychosocial concomitants of abnormal illness behaviour in patients with cancer. Psychother Psychosom 65(5):246–252

    Article  Google Scholar 

  12. Grassi L, Biancosino B, Marmai L, Righi R (2004) Effect of reboxetine on major depressive disorder in breast cancer patients: an open-label study. J Clin Psychiatry 65:4

    Google Scholar 

  13. Grassi L, Buda P, Cavana L, Annunziata MA, Torta R, Varetto A (2005) Styles of coping with cancer: the Italian version of the mini-mental adjustment to cancer (MINI-MAC) scale. Psychooncology 14(2):115–124

    Article  PubMed  Google Scholar 

  14. Grassi L, Mangelli L, Fava GA, Grandi S, Ottolini F, Porcelli P, Rafanelli C, Rigatelli M, Sonino N (2007) Psychosomatic characterization of adjustment disorders in the medical setting: some suggestions for DSM-V. J Affect Disord 101(1–3):251–254

    Google Scholar 

  15. Guy W (1976) ECDEU assessment manual for psychopharmacology, revised. US National Institute of Health, Psychopharmacology Research Branch, Rockville, MD, pp 223–244

    Google Scholar 

  16. Hawley CJ, Gale TM, Sivakumaran T (2002) Defining remission by cut off score on the MADRS: selecting the optimal value. J Affect Disord 72:177–184

    Article  PubMed  CAS  Google Scholar 

  17. Holland JC, Romano SJ, Heiligenstein JH et al (1998) A controlled trial of fluoxetine and desipramine in depressed women with advanced cancer. Psychooncology 7(4):291–300

    Article  PubMed  CAS  Google Scholar 

  18. Insel TR, Charney DS (2003) Research on major depression. JAMA 289:3167–3168

    Article  PubMed  Google Scholar 

  19. McDaniel JS, Musselman DL, Porter MR, Porter MR, Reed DA, Nemeroff CB (1995) Depression in patients with cancer: diagnosis, biology, and treatment. Arch Gen Psychiatry 52:89–99

    PubMed  CAS  Google Scholar 

  20. Montgomery SA, Asberg M (1979) A new depression scale designed to be sensitive to change. Brit J Psychiatry 134:382–389

    Article  CAS  Google Scholar 

  21. Morrow GR, Hickok JT, Roscoe JA, Raubertas RF, Andrews PLR, Flynn PJ, Hynes HE, Banerjee TK, Kirshner JJ, King DK (2003) Differential effects of paroxetine on fatigue and depression: a randomized double-blind trial from the University of Rochester Cancer Centre Community Clinical Oncology Program. J Clin Oncol 21:4635–4641

    Article  PubMed  CAS  Google Scholar 

  22. Musselman DL, Lawson DH, Gumnick JF, Manatunga AK, Penna S, Goodkin RS, Greiner K, Nemeroff CB, Miller AH (2001) Paroxetine for the prevention of depression induced by high-dose interferon alfa. N Engl J Med 344:961–966

    Article  PubMed  CAS  Google Scholar 

  23. Newport DJ, Nemeroff CB (1998) Assessment and treatment of depression in the cancer patient. J Psychosom Res 45:215–237

    Article  PubMed  CAS  Google Scholar 

  24. Pezzella G, Moslinger-Gehmayr R, Contu A (2001) Treatment of depression in patients with breast cancer: a comparison between paroxetine and amitriptyline. Breast Cancer Res Treat 70(1):1–10

    Article  PubMed  CAS  Google Scholar 

  25. Plouffe L, Trott E, Largoza M et al (1997) An open trial of sertraline for menopausal hot flashes: potential involvement of serotonin in vasomotor instability. Del Med J 69:481–482

    PubMed  Google Scholar 

  26. Preskorn SH (1997) Clinically relevant pharmacology of selective serotonin reuptake inhibitors. An overview with emphasis on pharmacokinetics and effects on oxidative drug metabolism. Clin Pharmacokinet 32(Suppl 1):1–21

    Article  PubMed  CAS  Google Scholar 

  27. Ryan H, Schofield P, Cockburn J, Butow P, Tattersall M, Turner J, Girgis A, Bandaranayake D, Bowman D (2005) How to recognize and manage psychological distress in cancer patients. Eur J Cancer Care 14:7–15

    Article  CAS  Google Scholar 

  28. Razavi D, Allilaire JF, Smith M, Salimpour A, Verra M, Desclaux B, Saltel P, Piollet I, Gauvain-Piquard A, Trichard C, Cordier B, Fresco R, Guillibert E, Sechter D, Orth JP, Bouhassira M, Mesters P, Blin P (1996) The effect of fluoxetine on anxiety and depression symptoms in cancer patients. Acta Psychiatr Scand 94:205–210

    Article  PubMed  CAS  Google Scholar 

  29. Reiche EM, Nunes SO, Morimoto HK (2004) Stress, depression, the immune system, and cancer. Lancet Oncol 5(10):617–625

    Article  PubMed  CAS  Google Scholar 

  30. Roscoe JA, Morrow GR, Hickok JT, Mustian KM, Griggs JJ, Matteson SE, Bushunow P, Qazi R, Smith B (2005) Effect of paroxetine hydrochloride (Paxil®) on fatigue and depression in breast cancer patients receiving chemotherapy. Breast Cancer Res Treat 89(3):243–249

    Article  PubMed  CAS  Google Scholar 

  31. Roth A, Scher H (1998) Sertraline relieves hot flashes secondary to medical castration as treatment of advanced prostate cancer. Psychooncology 7:129–132

    Article  PubMed  CAS  Google Scholar 

  32. Sheikh JI, Cassidy EL, Doraiswamy PM, Salomon RM, Horning M, Holland PJ, Mandel FS, Clary CM, Burt T (2004) Efficacy, safety and tolerability of sertraline in patients with late-life depression and comorbid medical illness. J Am Geriatr Soc 52:86–92

    Article  PubMed  Google Scholar 

  33. Somerset W, Stout SC, Miller AH, Musselman D (2004) Breast cancer and depression. Oncology (Williston Park) 18(8):1021–1034

    Google Scholar 

  34. Spitzer WO, Dobson AJ, Hall J, Chesterman E, Levi J, Shepherd R, Battista RN, Catchlove BR (1981) Measuring the quality of life of cancer patients. A concise QL-index for use by physicians. J Chronic Dis 34(12):585–597

    Article  Google Scholar 

  35. Torta R, Mussa A (eds) (1997) Psiconcologia. Basi biologiche, aspetti clinici ed approcci terapeutici. Centro Scientifico Editore, Torino

    Google Scholar 

  36. Torta R, Amodeo L, Berra C, Borio R, Caldera P, Scalabrino A (2003) Lo spettro di impiego degli psicofarmaci in oncologia. Ital J Psychopathol 9 Suppl

  37. Torta R (2006) Depression as a systemic disease: the antidepressants spectrum of action. Psychooncology 15(S2):2–3

    Google Scholar 

  38. Van Heeringen K, Zivkov M (1996) Pharmacological treatment of depression in cancer patients. A placebo-controlled study of mianserin. Br J Psychiatry 169:440–443

    Article  PubMed  Google Scholar 

  39. Watson M, Law M, dos Santos M (1992) Coping with cancer: the Mini-MAC. ICPO, Beaune

    Google Scholar 

  40. World Medical Association (2002) Declaration of Helsinki: ethical principles for medical research involving human subject. 52nd WMA General Assembly. Edinburgh, Scotland (October)

    Google Scholar 

  41. Wu W, Yamaura T, Murakami K, Murata J, Matsumoto K, Watanabe H, Saiki I (2000) Social isolation stress enhanced liver metastasis of murine colon 26-L5 carcinoma cells by suppressing immune responses in mice. Life Sci 66(19):1827–1838

    Google Scholar 

  42. Wu W, Murata J, Hayashi K, Yamaura T, Mitani N, Saiki I (2001) Social isolation stress impairs the resistance of mice to experimental liver metastasis of murine colon 26-L5 carcinoma cells. Biol Pharm Bull 24(7):772–776

    Google Scholar 

  43. Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67:361–370

    Article  PubMed  CAS  Google Scholar 

Download references

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Authors and Affiliations

  1. SCDU Psicologia Clinica e Oncologica, Ospedale San Giovanni Battista di Torino, corso Bramante 86/88, cap 10126, Turin, Italy

    Riccardo Torta, Ilaria Siri & Paola Caldera

Authors
  1. Riccardo Torta
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  2. Ilaria Siri
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  3. Paola Caldera
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Correspondence to Riccardo Torta or Paola Caldera.

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Torta, R., Siri, I. & Caldera, P. Sertraline effectiveness and safety in depressed oncological patients. Support Care Cancer 16, 83–91 (2008). https://doi.org/10.1007/s00520-007-0269-0

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  • DOI: https://doi.org/10.1007/s00520-007-0269-0

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