Navari, R.M., Brenner, M.C., & Wilson, M.N. (2008). Treatment of depressive symptoms in patients with early stage breast cancer undergoing adjuvant therapy. Breast Cancer Research and Treatment, 112, 197–201.

To investigate whether the oral antidepressant fluoxetine affected symptoms of depression, adjuvant treatment completion, or quality of life

Intervention was daily oral fluoxetine (20 mg) for 6 months. Fluoxetine is a selective serotonin reuptake inhibitor. Data were collected at baseline, 3 months, and 6 months.

• The sample size was 180 (90 in the intervention group and 90 in the control group).
• Patients' mean age was 55.9 (range = 37–85).
• All patients were female.
• Patients had stage I or II breast cancer only.
• Patients had symptoms of depression but not a diagnosis of depression.

Four community outpatient settings

Active treatment

Prospective, randomized, placebo-controlled trial with double blinding

• The Functional Assessment of Cancer Therapy-General (version 3) for quality of life.
• The completion of adjuvant treatment was recorded.
• 11-item brief Zung Self-Rating Depression Scale for depressive symptoms.
• Two-question screening survey (TQSS) at baseline, to screen patients with symptoms of depression.

The use of fluoxetine for six months in each adjuvant therapy group (chemotherapy alone, hormonal therapy alone, chemotherapy plus hormonal therapy), was associated with, compared to the control group:

• An improvement in quality of life (p < 0.01 in each group)
• A higher completion of adjuvant treatment (p < 0.01 in each group)
• A reduction in symptoms of depression (p < 0.01 in each group).

An antidepressant may be effective for patients with early-stage breast cancer who have symptoms of depression and who are receiving adjuvant treatment. Given study limitations, more evidence is needed.

• The time lapsed since cancer therapy was unknown.
• The number of patients who showed a significant improvement in each measurement was statistically tested. However, it is unclear how the significant improvement was determined. Data for both the main outcome measures (quality of life and depression) were not reported.
• No data were recorded about reliability, validity, sensitivity, or specificity for TQSS.
• The study included patients with early-stage breast cancer only, and the size of each adjuvant therapy subgroup was small.

Oncology nurses can inform patients that oral fluoxetine may be an option for decreasing symptoms of depression.