Ostuzzi, G., Benda, L., Costa, E., & Barbui, C. (2015). Efficacy and acceptability of antidepressants on the continuum of depressive experiences in patients with cancer: Systematic review and meta-analysis. Cancer Treatment Reviews, 41, 714–724.
Antidepressants were effective in reducing distressing symptoms (SMD = -0.229, p = 0.018) and major depression or depressive symptoms (SMD = -0.285, p = 0.001). All types of antidepressants showed some efficacy, although tricyclic antidepressants did not show efficacy across two small studies. SSRIs and manserin were effective. Quality of life measures were also improved. There was significant heterogeneity. Analysis showed significant efficacy was correlated with length of follow up (p < 0.001). Antidepressants did not differ from placebo in terms of acceptability, using drop-out rate as a proxy of acceptability.
Antidepressants of all types demonstrated overall efficacy for improvement in depressive symptoms as well as other distressing symptoms. SSRIs and manserin showed the best results
Overall quality of reports was graded as low to moderate. Several studies included funding by drug companies, suggesting sponsorship bias as the funder role was not described. There was significant heterogeneity
Findings from this analysis show that antidepressants, particularly SSRIs and manserin, were tolerable and effective in reducing depressive symptoms in patients with cancer. Findings also suggest that efficacy may increase over time, pointing to the potential need for sufficient duration of treatment. It is important that nurses screen for symptoms of depression among patients with cancer, and facilitate relevant treatment.