Ostuzzi, G., Matcham, F., Dauchy, S., Barbui, C., & Hotopf, M. (2015). Antidepressants for the treatment of depression in people with cancer. Cochrane Database of Systematic Reviews, 6, CD011006. 

DOI Link

Purpose

STUDY PURPOSE: Assess effects of antidepressants among people with cancer for treatment of depression

TYPE OF STUDY: Meta-analysis and systematic review

Search Strategy

DATABASES USED: MEDLINE, EMBASE, CENTRAL, and PsycINFO and hand searching of drug approval agencies
 
KEYWORDS: Extensive lists of search terms per database are provided
 
INCLUSION CRITERIA: Randomized trials comparing any antidepressant with placebo or another antidepressant. Adult patients 
 
EXCLUSION CRITERIA: Trials in which antidepressants were compared to another agent such as stimulants, antipsychotics, etc.

Literature Evaluated

TOTAL REFERENCES RETRIEVED: 4,498
 
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: Cochrane risk of bias assessment

Sample Characteristics

  • TOTAL PATIENTS INCLUDED IN REVIEW = 861
  • FINAL NUMBER STUDIES INCLUDED = 9, with 7 used in meta-analysis
  • SAMPLE RANGE ACROSS STUDIES: 35-93
  • KEY SAMPLE CHARACTERISTICS: Majority were in patients with breast cancer

 

Results

There was no differences between antidepressants as a class and placebo in five RCTs, no difference between groups comparing different antidepressants, and no difference in drop-out rates between placebo and antidepressants

Conclusions

The findings did not provide strong evidence for efficacy of antidepressants.

Limitations

Study quality was generally low with unclear risk of bias in multiple aspects of the study design and implementation. In five studies, risk of bias due to conflict of interest was questionable. There was no difference found between SSRIs and tricyclic antidepressants. Studies included were all conducted prior to 2009.

Nursing Implications

This particular analysis did not demonstrate efficacy of antidepressants in patients with cancer for management of depressive symptoms. There were multiple limitations in this analysis due to the low quality of the studies included.

Legacy ID

5702