Evaluation of the effectiveness, safety, and acceptability of antidepressants drugs in cancer patients: an overview of systematic reviews
DOI:
https://doi.org/10.59255/mmed.2025109Keywords:
antidepressants, depression, neoplasms, quality of life, systematic review, clinical trialAbstract
Introduction: Depression is prevalent among cancer patients, compromising quality of life and adherence to oncological treatment. Antidepressant use is frequent in this context, but evidence regarding their effectiveness, safety, and acceptability remains uncertain. Aim: To evaluate the effectiveness, safety, and acceptability of antidepressant use in cancer patients undergoing antineoplastic treatment. Methods: The guiding question of this review was: what is the effectiveness, safety, and acceptability of pharmacological treatment for depression in adult cancer patients? An overview of systematic reviews was conducted, with searches performed in PubMed and LILACS, including publications in Portuguese, English, and Spanish. Reviews investigating antidepressants in adults diagnosed with cancer and depression were independently selected by two researchers. Results: Nine systematic reviews were included, comprising randomized clinical trials published between 1985 and 2019. Mianserin showed consistent results of greater effectiveness compared with placebo. Fluoxetine, paroxetine, escitalopram, and reboxetine also demonstrated benefit, although with greater variability in outcomes. Safety was considered acceptable for most drugs, except for fluoxetine and paroxetine, which were associated with a higher occurrence of adverse events. Acceptability varied according to the drug, being more favorable for mianserin. Conclusion: Antidepressants show potential in managing depression in cancer patients, particularly mianserin and some SSRIs. However, the heterogeneity and methodological limitations of the studies highlight the need for higher-quality clinical trials to support robust clinical recommendations.
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