- Available evidence from randomized controlled trials (RCTs) is inadequate to guide use of antidepressants for treating depression in people with cancer.
Why this matters
- There is no clear guidance emerging from the body of evidence; consequently, the choice of antidepressants should be individualized based on efficacy in patients with major depression.
- Good treatment of depression has the potential to improve QoL, increase compliance with anticancer therapy, and reduce suicide risk.
- This Cochrane systematic review of 10 randomized controlled trials identified 885 participants with a primary diagnosis of cancer and depression.
- Funding: Department of Public Health and Community Medicine and others.
- No significant difference was noted in efficacy (6-12 weeks) between antidepressants and placebo:
- Efficacy as a continuous outcome (standardized mean difference, −0.45 [95% CI, −1.01 to 0.11; 5 studies; n=266]).
- There was no significant difference between the efficacy of selective serotonin reuptake inhibitors (SSRIs) vs tricyclic antidepressants (TCAs; risk ratio, 1.10; 95% CI, 0.78-1.53; 2 RCTs; n=199).
- Similarly, there was no evidence of a difference in terms of acceptability and tolerability for antidepressants vs placebo and SSRIs vs TCAs.
- Very low certainty of evidence.
- Interpretation of results should remain provisional.
Coauthored with Chitra Ravi, MPharm