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Escitalopram during cancer treatment reduces depression.


LOS ANGELES--Prophylactic escitalopram reduces the risk for depression in patients undergoing treatment for head and neck cancer, according to findings from a randomized placebo-controlled trial involving 148 patients.

Of those randomized to receive the selective serotonin reuptake inhibitor, 10% developed moderate to severe depression during the course of their cancer treatment, compared with 24.6% of those who received placebo, Dr. William J. Burke reported in a poster at the annual meeting of the American Association for Geriatric Psychiatry.

After adjustment for age, baseline smoking status, and stratification variables, including sex, cancer site, cancer stage, and primary treatment modality, those receiving active treatment remained significantly less likely to develop depression (hazard ratio, 0.37), said Dr. Burke of the University of Nebraska Medical Center, Omaha. Of note, patients undergoing radiotherapy as the primary treatment modality were significantly more likely than those undergoing surgery as the primary treatment modality to develop depression (HR, 3.6).

Patients in the escitalopram group who did not become depressed during the course of the study reported a significantly better quality of life for 3 consecutive months after escitalopram cessation than did those in either the treatment or placebo group who did develop depression.

Patients included in this double-blind study had head and neck cancers and were about to enter cancer treatment. Depression was assessed using the QIDS-SR(Quick Inventory of Depressive Symptomatology-Self Rated).

The findings have important implications for the management of patients entering treatment for head and neck cancer.

For example, larynx and tongue cancers comprise only 2% of all cancers, but patients with these cancers commit 19% of all cancer-related suicides. Dr. Burke noted. Up to half of all patients with head and neck cancer develop major depressive disorderl. "Preventing depression during the course of cancer treatment may, thus, be of great benefit," he said.


Major finding: During cancer treatment, 10% of the treatment group developed depression, vs. 24.6% of the placebo group.

Data source: A randomized, double-blind, placebo-controlled trial involving 148 patients.

Disclosures: The project was supported by a grant from the National Institute of Mental Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIMH or the National Institutes of Health. Additional support was provided by a research support fund grant from the Nebraska Medical Center and the University of Nebraska Medical Center. Forest Pharmaceuticals provided the matching placebo and drugs.
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Author:Worcester, Sharon
Publication:Clinical Psychiatry News
Date:Sep 1, 2013
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