Amisulpride in the short-term treatment of depressive and physical symptoms in cancer patients during chemotherapies.
BACKGROUND
Amisulpride is a substituted benzamide that, at low doses, selectively blocks D2 and D3 presynaptic dopamine receptors, enhancing dopaminergic transmission in frontal cortex and limbic areas. Many clinical studies versus placebo, tricyclic antidepressants and selective serotonin reuptake inhibitors showed amisulpride antidepressant effect, supporting its safety and rapid onset of action. In oncological population, depression is quite frequent and difficult to treat because of the particular sensitivity of cancer patients to the antidepressants' side effects.


OBJECTIVE
The aims of this study were to evaluate efficacy, safety and tolerability of low doses of amisulpride (50 mg) in oncological, depressed patients during chemotheraphy.


METHODS
One hundred six consecutive cancer outpatients with depressive symptoms were treated in a prospective, intention to treat, 4-week study, and were evaluated in single-blind with Montgomery Asberg rating scale for depression (MADRS), clinical global impression (CGI) and dosage record treatment emergent symptom scale (DOTES) to assess side effects of treatment.


RESULTS
After 4 weeks of treatment, scores of MADRS and CGI significantly improved (p < 0.002; p < 0.001, respectively), with a reduction of depressive symptoms concerning both emotional (such as apparent sadness, reported sadness, inner tension, etc.) and physical cluster (such as lack of appetite, reduction in weight, tiredness and insomnia) with good tolerability (only two patients dropped out).


CONCLUSIONS
This study is the first trial on the use of amisulpride in a cohort of oncological, depressed patients during chemotherapy. Amisulpride demonstrated high efficacy and safety. Controlled studies are needed to confirm these preliminary data.
Torta
Riccardo
R
SCDU Psicologia Clinica e Oncologica, Ospedale San Giovanni Battista di Torino, Turin, Italy. riccardo.torta@unito.it
Berra
Carlotta
C
Binaschi
Luca
L
Borio
Roberto
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000077582:Amisulpride; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D015331:Cohort Studies; D003863:Depression / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D007558:Italy; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy / Q000523:psychology*; D017063:Outcome Assessment, Health Care; D016037:Single-Blind Method; D013469:Sulpiride / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use
D014150:Antipsychotic Agents; D013469:Sulpiride; D000077582:Amisulpride