THE EFFECT OF FLUOXETINE ON ANXIETY AND DEPRESSION SYMPTOMS IN CANCER-PATIENTS

Little has been done to study the effectiveness of antidepressants in controlling anxiety/depression in a population of cancer patients. A d ouble-blind placebo-controlled study was therefore designed to assess the effectiveness of 20 mg fluoxetine, Of 115 cancer patients who fulf illed entry criteria for levels of distress, 45 patients were randomiz ed to a fluoxetine treatment group (FA) and 46 patients to a placebo g roup (PA) after a 1-week placebo period designed to exclude placebo re sponders. The Montgomery and Asberg Depression Scale (MADRS), the Hami lton Anxiety Scale (HAS), the Hospital Anxiety and Depression Scale (H ADS), the Revised Symptom Checklist (SCL90-R) and the Spitzer Quality of Life Index (SQOLI) were used to assess the efficacy of fluoxetine. The response rate, defined by a HADS score lower than 8 after 5 weeks of treatment, was not significantly higher in the FA group (11%) compa red to the PA group (7%). Compared to the PA group, patients in the FA group showed a significantly greater decrease in SCL90-R mean total s core after 5 weeks, but not a greater decrease in HADS mean score. No difference between the two groups was found in observer-reported asses sments (MADRS, HAS and SQOLI). Significantly more drop-outs were obser ved in the FA group (n=15) than in the PA group (n=7), although the fr equencies of side-effects were not significantly different.