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
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N = 52
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MEAN AGE: 18-70 years
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FEMALES: 100%
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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.
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OTHER KEY SAMPLE CHARACTERISTICS: No other psychotropic medication and no behavioral intervention therapy.
Setting
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SITE: Single site
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SETTING TYPE: Outpatient
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LOCATION: Tehran, Iran
Phase of Care and Clinical Applications
PHASE OF CARE: Active antitumor treatment
APPLICATIONS: Palliative care
Study Design
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Single center, double-blind, controlled, parallel group
Measurement Instruments/Methods
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DSM-IV-TR to diagnose
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HDRS
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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
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Small sample (less than 100)
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Risk of bias (no control group)
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Findings not generalizable
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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.