Alamdarsaravi, M., Ghajar, A., Noorbala, A.A., Arbabi, M., Emami, A., Shahei, F., . . . Akhondzadeh, S. (2017). Efficacy and safety of celecoxib monotherapy for mild to moderate depression in patients with colorectal cancer: A randomized double-blind, placebo controlled trial. Psychiatry Research, 255, 59–65.

To assess the safety and efficacy of celecoxib single therapy on depressive symptoms of patients with colorectal cancer who underwent chemotherapy.

Parallel-group, randomized, double-blind, placebo-controlled trial, randomized to either 400 mg per day celecoxib or placebo for 6 weeks.

• N = 40
• AGE: 18-65 years
• MALES: 65% in celecoxib arm; 55% in placebo arm  
• FEMALES: Not listed
• CURRENT TREATMENT: Chemotherapy
• KEY DISEASE CHARACTERISTICS: Stage I–IV colorectal cancer diagnosed more than 100 days 
• OTHER KEY SAMPLE CHARACTERISTICS: 15% in celecoxib group and 20% in placebo group reported past psychiatry history

• SITE: Single site   
• SETTING TYPE: Outpatient    
• LOCATION: Tehran University of Medical Sciences, Tehran, Iran

PHASE OF CARE: Active anti-tumor treatment

Parallel-group, randomized, double-blind, placebo-controlled trial

Hamilton Depression Rating Scale, Visual Analog Scale to measure pain intensity, at week 2, 4, and 6 post-treatment. Adverse events were evaluated at each point using a checklist. Medication adherence was measured with weekly capsule counts with participant reports of medication intake.

HRDS scores were significantly greater in the celecoxib treatment group at week 2 and remained higher until week 6 (p = 0.028). There was not a significant difference between mean VAS scores between the groups at week 2, 4, and 6 (p = 0.459). Gastrointestinal side effects that have been attributed to celecoxib, such as abdominal pain and diarrhea, were not significantly different between the intervention groups. No symptoms of cardiovascular adverse event or serious adverse event occurred.

Celecoxib monotherapy is potentially safe and effective treatment for mild to moderate depression in patients with colorectal cancer undergoing chemotherapy.

Small sample (< 100)

Oncology nurses are in a key position to screen for psychological distress in patients undergoing chemotherapy. Celecoxib has been shown in this study to be effective for mild to moderate depression in patients with colorectal cancer. Celecoxib may also be effective in patients with other malignancies although further research is needed. Oncology nurses should discuss with physicians the use of celecoxib for any patients with colorectal cancer exhibiting mild to moderated depression as evidenced on psychological distress screening.