Jc. Holland et al., A CONTROLLED TRIAL OF FLUOXETINE AND DESIPRAMINE IN DEPRESSED WOMEN WITH ADVANCED CANCER, Psycho-oncology (Chichester), 7(4), 1998, pp. 291-300
Background. This study was conducted to determine the efficacy and tol
erability of fluoxetine and desipramine in treating depressive symptom
s in women with cancer. Method. In this prospective, 6-week, double-bl
ind, placebo-controlled trial, we compared fluoxetine with desipramine
in treating depressive symptoms in 40 women diagnosed with cancer. Sc
ales used to measure efficacy and tolerability were the Hamilton Depre
ssion Rating Scale (HAM-D), the Hamilton Anxiety Rating Scale (HAM-A),
the Clinical and Patient's Global Impression (CGI and PGI) scales, th
e Functional Living Index for Cancer (FLIC), the Memorial Pain Assessm
ent Card (MPAC), and the SF-36 Health Survey. Results. Fluoxetine and
desipramine treatments improved depression and anxiety symptoms. There
was a trend towards significance in improvement of FLIC scores (as ev
idenced by greater numerical improvements with fluoxetine treatment).
Fluoxetine treatment alone was associated with statistically significa
nt improvements in MPAC Mood scale scores. Both treatments showed stat
istically significant improvements in the quality of life SF-36 scores
in Role Emotional, Social Functioning, Mental Health, and Vitality. C
onclusions. Both fluoxetine and desipramine were effective and well-to
lerated in improving depressive symptoms and quality of life in women
with advanced cancer. Fluoxetine may offer greater benefit to these pa
tients, as evidenced by greater improvements in fluoxetine-treated pat
ients on several quality of life measures. Our results, while meaningf
ul, should be confirmed in a larger patient sample. However, experienc
e from studies of antidepressant use in patients with advanced cancer
has shown that intercurrent disease and treatment variables make it di
fficult to conduct large studies. (C) 1998 John Wiley & Sons, Ltd.