Effect of reboxetine on major depressive disorder in breast cancer patients: an open-label study.
BACKGROUND
Depression is a common disorder in cancer patients, and it is associated with reduced quality of life, abnormal illness behavior, pain, and suicide risk. A few studies have investigated the effects of tricyclic antidepressants and serotonin reuptake inhibitors in cancer patients. No data are available regarding the use of reboxetine, a norepinephrine reuptake inhibitor that has been shown to be safe (e.g., absence of clinically significant drug-drug interactions and cytochrome P450 metabolism) and effective in the treatment of depressed patients, including those with medical illness (e.g., Parkinson's disease, human immunodeficiency virus infection).


METHODS
The effects of reboxetine were investigated in 20 breast cancer patients with a DSM-IV diagnosis of major depressive disorder in an open, prospective 8-week trial. Severity of depression was assessed with the 17-item Hamilton Rating Scale for Depression (HAM-D). Psychiatric symptoms (Brief Symptom Inventory [BSI]), styles of coping with cancer (Mini-Mental Adjustment to Cancer [Mini-MAC]), quality of life (European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire C30 [EORTC-QLQ-C30]), and Clinical Global Impressions scale scores were also monitored.


RESULTS
At 8 weeks, a significant (p <.01) reduction was observed in HAM-D scores, several BSI dimension scores, and Mini-MAC hopelessness and anxious preoccupation scores. A significant (p <.05) improvement from baseline to endpoint was found on the EORTC-QLQ-C30 subfactors emotional, cognitive, dyspnea, sleep, and global. Discontinuation was necessary in 1 subject because of hypomanic switch and in another because of side effects (tachycardia, tension). Seven patients experienced transient side effects (e.g., mild anxiety, insomnia, sweating).


CONCLUSIONS
In this open trial, reboxetine appeared to be well tolerated and promising in reducing depressive symptoms and maladjusted coping styles and in improving scores on quality-of-life parameters.
Grassi
Luigi
L
Department of Medical Sciences of Communication and Behavior, Section of Psychiatry, University of Ferrara, Corso Giovecca 203, 44100 Ferrara, Italy. luigi.grassi@unife.it
Biancosino
Bruno
B
Marmai
Luciana
L
Righi
Roberto
R
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000150:complications / Q000523:psychology*; D003866:Depressive Disorder / Q000188:drug therapy* / Q000209:etiology / Q000523:psychology; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008875:Middle Aged; D009025:Morpholines / Q000627:therapeutic use*; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D000077593:Reboxetine; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000928:Antidepressive Agents; D009025:Morpholines; D000077593:Reboxetine