The prevalence and pharmacotherapy of depression in cancer patients.
BACKGROUND
Depression is a frequent and serious comorbid condition in cancer patients that may require special attention. We investigate the prevalence of depression in cancer and review the current state of evidence regarding the effectiveness of drug treatment of depression in this group.


METHODS
We conducted a literature search for reports of prevalence rate of Major Depressive Disorder (MDD) in cancer patients based on Structured Clinical Interview based on DSM (SCID). We estimated the prevalence rate by combining the data of all reports. In addition we identified controlled trials studying the effect of psychotropic drugs in depressed cancer patients.


RESULTS
Based on the 31 reports, the estimated prevalence rate of depression in cancer patients is 10.8% (996/9248). There were 8 trials comparing antidepressant with other active treatment in cancer patients. Only mianserin and alprazolam demonstrated to improve the depressive symptoms.


CONCLUSIONS
This literature review cannot resolve the challenge of diagnosing depression in severely ill and is subject to publication bias.


CONCLUSIONS
Despite the high prevalence of depression in cancer patients, studies on effective pharmacotherapy are relatively scarce. The evidence for the efficacy of conventional medication used for the treatment of depression such as tricyclics antidepressants and selective serotonin reuptake inhibitors is very limited. It is possible that they may be less suitable in this setting because of their relatively late onset of action. The use of psychostimulants which have a rapid onset of action therefore deserves more attention.
Ng
Chong Guan
CG
Julius Center for Health Sciences and Primary Care, University Medical Centre, Utrecht, The Netherlands. chong_guan@hotmail.com
Boks
Marco P M
MP
Zainal
Nor Zuraida
NZ
de Wit
Niek J
NJ
D000928:Antidepressive Agents / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D009369:Neoplasms / Q000150:complications / Q000523:psychology*; D015995:Prevalence
D000928:Antidepressive Agents