Park, H.Y., Lee, B.J., Kim, J.H., Bae, J.N., & Hahm, B.J. (2012). Rapid improvement of depression and quality of life with escitalopram treatment in outpatients with breast cancer: A 12-week, open-label prospective trial. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 36, 318–323.doi: 10.1016/j.pnpbp.2011.11.010
To investigate the effectiveness and tolerability of open-label treatment with escitalopram in patients with breast cancer who have major depressive disorder
Patients received escitalopram at 5 mg/day in week 1. After week 1, the dose was adjusted to 5–20 mg/day. Patients were evaluated at baseline, 1, 2, 4, 8, and 12 weeks.
Outpatient settings in the Republic of Korea
Transition phase after initial treatment
62 patients were included in the efficacy analysis, and only 45.6% completed the full 12-week study. Dropouts occurred because of lack of efficacy, no symptom improvement, side effects, and unspecified reasons. 34% of the sample dropped out due to lack of effectiveness or no change in symptoms.
Significant decreases were seen at week 1 and forward in HAMD (p < 0.001), DT (p < 0.001), and CGI-S (p < 0.003). FACT-B scores improved after week 2 (p = 0.011). No differences were observed in baseline scores between responders and nonresponders.
No serious adverse events were reported. The most common side effects were dry mouth, drowsiness, constipation, and increased sweating. Sleep disturbance, shortness of breath, and sadness were improved, but pain, fatigue, and anorexia did not improve.
Escitalopram reduced depression in some patients with breast cancer who had major depressive disorder.
Escitalopram may be an effective treatment for symptoms of depression in some patients with breast cancer; however, about a third of patients in the study did not experience an effect. Nurses should be aware of side effects that may worsen existing symptoms.