According to a study conducted at Emory
University, the prophylactic use of antidepressants is successful in preventing depression, anxiety, and physical distress in cancer
patients. The study, published in the New England Journal of Medicine
(344:961-966, 2001), found that providing the antidepressant paroxetine (Paxil)
2 weeks before beginning cancer treatment significantly reduced the development
of clinical depression. In addition, the number of patients who had to
discontinue cancer treatment because of severe emotional or physical distress
was also reduced.
Andrew Miller, MD, professor, department of psychiatry and
behavioral sciences at Emory University School of Medicine, and his colleagues
at the Winship Cancer Institute and Rollins School of Public Health studied 40
patients with malignant melanoma. Their objective was to prevent depression by
treating patients who were about to be given interferon-alpha, an agent
predominantly used to treat malignant disorders and infectious diseases.
Although an effective therapy, interferon-alpha has been associated with high
rates of central nervous system side effects, including the development of
severe depression that in some instances has led to suicide.
Significant Prophylactic Effect
Patients were randomly assigned a placebo or paroxetine. Almost
50% of patients who received the placebo became significantly depressed while
receiving cancer treatment vs only about 10% in the paroxetine group.
"Patients who received the antidepressant also experienced
significantly less anxiety, fewer concentration and memory problems, and far
less intense physical symptoms such as abdominal discomfort, pain, and
fatigue," said Dr. Miller. "We wonder whether such an approach may
have broader applications, including prevention of physical and emotional
complications of other cancer treatments and, possibly, even major
These data provide the first demonstration of the prophylactic
use of antidepressants in medically ill patients at high risk for