title: Celecoxib Versus Diclofenac in Mild to Moderate Depression Management Among Breast Cancer Patients: A Double-Blind, Placebo-Controlled, Randomized Trial.
abstract: BACKGROUND
  Depression is a well-known complication of breast cancer, which is known to adversely affect quality of life, prognosis, and survival in breast cancer patients. Celecoxib, a nonsteroidal anti-inflammatory drug, which acts via the selective inhibition of cyclo-oxygenase (COX)-2, has been shown to have antidepressive effects.
  
  
  OBJECTIVE
  Here, we aimed to compare the efficacy and safety of celecoxib, a selective inhibitor of COX-2, with diclofenac, a nonselective inhibitor of both COX-1 and COX-2 in reducing depressive symptoms and pain in breast cancer patients.
  
  
  METHODS
  A total of 52 outpatients with breast cancer with mild to moderate depression, who suffered from pain and needed analgesics, participated in the trial and underwent 6 weeks of treatment with either celecoxib (200 mg twice daily) or diclofenac (50 mg twice daily). Participants were investigated using the Hamilton Depression Rating Scale (HDRS). The primary outcome measure was to compare the antidepressant effects of celecoxib and diclofenac.
  
  
  RESULTS
  Repeated-measures analysis demonstrated significant effect for Time × Treatment interaction on the HDRS scores: F(1.76, 87.85) = 9.66; P < 0.001. By study conclusion, greater improvement was observed in the HDRS score of the celecoxib group compared with the diclofenac group (P = 0.002). No one experienced remission (HDRS ≤ 7) in either group. Frequencies of adverse events were not significantly different between groups.
  
  
  CONCLUSIONS
  Celecoxib seems to possess superior antidepressive effects compared with diclofenac in breast cancer patients with mild to moderate depression.
authors.affiliation: Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Payam
authors.initials: P
authors.lastname: Mohammadinejad
authors.affiliation: Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Pantea
authors.initials: P
authors.lastname: Arya
authors.affiliation: Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Esfandbod
authors.affiliation: Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Kaviani
authors.affiliation: Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Masoome
authors.initials: M
authors.lastname: Najafi
authors.affiliation: Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Ladan
authors.initials: L
authors.lastname: Kashani
authors.affiliation: Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Atefeh
authors.initials: A
authors.lastname: Zeinoddini
authors.affiliation: Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Seyed Amirhossein
authors.initials: SA
authors.lastname: Emami
authors.affiliation: Tehran University of Medical Sciences, Tehran, Iran s.akhond@neda.net.
authors.forename: Shahin
authors.initials: S
authors.lastname: Akhondzadeh
mesh_terms: D000700:Analgesics / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000523:psychology*; D000068579:Celecoxib / Q000627:therapeutic use*; D052246:Cyclooxygenase 2 Inhibitors / Q000627:therapeutic use*; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use*; D003863:Depression / Q000188:drug therapy* / Q000523:psychology; D004008:Diclofenac / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life
chemical_list: D000700:Analgesics; D000928:Antidepressive Agents; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors; D004008:Diclofenac; D000068579:Celecoxib
keywords: COX-2 inhibitors; anti-inflammatory agents; breast neoplasms; celecoxib; depression; diclofenac