Pharmacological treatment of depression in patients with a primary brain tumour.
BACKGROUND
Patients with a primary brain tumour often experience depression, for which drug treatment may be prescribed. However, these patients are also at high risk of epileptic seizures, cognitive impairment and fatigue, all of which are potential side-effects of antidepressants. The benefit, or harm, of pharmacological treatment of depression in brain tumour patients is unclear.


OBJECTIVE
To assess the benefits and harms of pharmacological treatment of depression in patients with a primary brain tumour.


METHODS
We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2009, Issue 3), MEDLINE (1950 to July 2009) and EMBASE (1980 to July 2009). We searched PsycINFO, the British Nursing Index, LILACS, Psyndex, the NHS National Research Register, the NHS Centre for Reviews and Disseminations' Database of Abstracts of Reviews of Effectiveness (DARE) and Web of Knowledge (covering Science Scisearch, Social Sciences Citation Index and Biological Abstracts) (up to July 2009). We handsearched Neuro-oncology, the Journal of Neuro-oncology, the Journal of Neurology, Neurosurgery and Psychiatry and the Journal of Clinical Oncology (July 1999 to June 2009) and wrote to all the pharmaceutical companies manufacturing antidepressants for use in the UK.


METHODS
We included all randomised controlled trials (RCTs), controlled clinical trials, cohort studies and case-control studies of any pharmacological treatment of depression in patients with a histologically diagnosed primary brain tumour.


METHODS
No studies met the inclusion criteria for this review.


RESULTS
We found no eligible studies evaluating the benefits or harms of any pharmacological treatment of depression in brain tumour patients suffering from depression.


CONCLUSIONS
No high-quality studies have examined the value of any drug treatment of depression in patients with primary brain tumours. Detailed prospective studies and RCTs are needed to inform the safe and effective treatment of this common and important complication of brain tumours.
Edinburgh Centre for Neuro-Oncology (ECNO), Western General Hospital, Crewe Road, Edinburgh, Scotland, UK, EH4 2XU.
Alasdair
A
Rooney
Robert
R
Grant
D001932:Brain Neoplasms / Q000523:psychology*; D003863:Depression / Q000188:drug therapy* / Q000209:etiology; D006801:Humans