Mohammadinejad, P., Arya, P., Esfandbod, M., Kaviani, A., Najafi, M., Kashani, L., . . . Akhondzadeh, S. (2015). Celecoxib versus diclofenac in mild to moderate depression management among breast cancer patients: A double-blind, placebo-controlled, randomized trial. Annals of Pharmacotherapy, 49, 953–961.

DOI Link

Study Purpose

To compare celecoxib versus diclofenac in mild to moderate depression in patients with breast cancer

Intervention Characteristics/Basic Study Process

Patients with breast cancer with mild to moderate depression and pain were randomized to receive celecoxib or diclofenac over a six-week period. Depression was evaluated at baseline, three weeks, and six weeks.

Sample Characteristics

  • N = 52
  • MEAN AGE: 18-70 years
  • FEMALES: 100%
  • KEY DISEASE CHARACTERISTICS: Patients had breast cancer for more than 100 days; major depression according to ​Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), 4th edition; a score of less than or equal to 18 on the Hamilton Depression Rating Scale (HDRS); and mild to moderate pain, and needed an analgesic.
  • OTHER KEY SAMPLE CHARACTERISTICS: No other psychotropic medication and no behavioral intervention therapy.

Setting

  • SITE: Single site
  • SETTING TYPE: Outpatient
  • LOCATION: Tehran, Iran

Phase of Care and Clinical Applications

PHASE OF CARE: Active antitumor treatment
APPLICATIONS: Palliative care 

Study Design

  • Single center, double-blind, controlled, parallel group

Measurement Instruments/Methods

  • DSM-IV-TR to diagnose
  • HDRS
  • Visual Analog Scale (VAS) mild to moderate pain (0-100) measured by need for analgesic

Results

Fifty-two patients randomized with similar characteristics showed a significant reduction in HDRS score in celecoxib group by week six; however, none achieved a remission of symptoms. There was no significant difference in VAS score.

Conclusions

There was a greater antidepressant effect for celecoxib than for diclofenac by week 6.

Limitations

  • Small sample (less than 100)
  • Risk of bias (no control group)
  • Findings not generalizable
  • Very short time frame; metastatic disease may have had an effect on results due to pain and prognosis

Nursing Implications

It is important to recognize that symptoms often present in clusters (pain/depression), and treatment of all symptoms are important to often achieve relief of any symptom.