Sarkar, S., & Schaefer, M. (2014). Antidepressant pretreatment for the prevention of interferon alfa-associated depression: A systematic review and meta-analysis. Psychosomatics, 55, 221–234. 

DOI Link

Purpose

STUDY PURPOSE: To assess whether pre-emptive antidepressants can reduce the incidence and severity of depression associated with interferon alpha
 
TYPE OF STUDY: Meta-analysis and systematic review

Search Strategy

DATABASES USED: PubMed, EMBASE, PsycINFO, and Cochrane
 
KEYWORDS: depress or MDD and prevention or prophylaxis and interferon and antidepressants
 
INCLUSION CRITERIA: Prospective controlled trials (RCTs), using interferon as monotherapy. Antidepressant administered before initiating interferon and for at least 12 weeks during treatment. Depression evaluated by DSM-IV criteria
 
EXCLUSION CRITERIA: Case series and retrospective studies

Literature Evaluated

TOTAL REFERENCES RETRIEVED: 120
 
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: No evaluation described for quality

Sample Characteristics

  • FINAL NUMBER STUDIES INCLUDED = 8
  • TOTAL PATIENTS INCLUDED IN REVIEW = 589
  • SAMPLE RANGE ACROSS STUDIES: 33–181
  • KEY SAMPLE CHARACTERISTICS: Included patients with hepatitis C. One study in melanoma

Phase of Care and Clinical Applications

PHASE OF CARE: Active antitumor treatment

Results

Analysis showed that antidepressant treatment reduced overall incidence of depressive disorder (OR = 0.42, p < 0.001). Only one trial was done in which patients with a history of depression were excluded.

Conclusions

Prophylactic use of antidepressants was associated with reduced incidence of depression in patients receiving interferon alpha monotherapy.

Limitations

  • There was only one study in patients with cancer.

Nursing Implications

Depression has been identified as an adverse effect of treatment with interferon alpha. This study showed that pre-emptive treatment with antidepressants can reduce the incidence of this effect. Nurses need to be aware of depression associated with interferon alpha treatment, and assess patients for depression, especially if they have a history of depressive symptoms. Long-term effects in patients with cancer are unknown, since there is limited evidence for this group of patients.

Legacy ID

5704