BACKGROUND: Fatigue can significantly interfere with a cancer patient's ability to fulfill daily responsibilities and enjoy life. It commonly co-exists with depression in patients undergoingchemotherapy, suggesting that administration of an antidepressant that alleviates symptoms of depression could also reduce fatigue. METHODS: We report on a double-blind clinical trial of 94 female breast cancer patients receiving at least four cycles ofchemotherapy randomly assigned to receive either 20 mg of the selective serotonin re-uptake inhibitor (SSRI) paroxetine (Paxil, SmithKline Beecham Pharmaceuticals) or an identical-appearing placebo. Patients began their study medication seven days following their first on-study treatment and continued until seven days following their fourth on-study treatment. Seven days after each treatment, participants completed questionnaires measuring fatigue (Multidimensional Assessment of Fatigue, Profile of Mood States-Fatigue/Inertia subscale and Fatigue Symptom Checklist) and depression (Profile of Mood States-Depression subscale [POMS-DD] and Center for Epidemiologic Studies-Depression [CES-D]). RESULTS: Repeated-measures ANOVAs, after controlling for baseline measures, showed that paroxetine was more effective than placebo in reducing depression during chemotherapy as measured by the CES-D (p = 0.006) and the POMS-DD (p = 0.07) but not in reducing fatigue (all measures, ps > 0.27). CONCLUSIONS: Although depression was significantly reduced in the 44 patients receivingparoxetine compared to the 50 patients receiving placebo, indicating that a biologically active dose was used, no significant differences between groups on any of the measures of fatigued were observed. Results suggest that modulation of serotonin may not be a primary mechanism of fatigue related to cancer treatment.
RCT Entities:
BACKGROUND:Fatigue can significantly interfere with a cancerpatient's ability to fulfill daily responsibilities and enjoy life. It commonly co-exists with depression in patients undergoing chemotherapy, suggesting that administration of an antidepressant that alleviates symptoms of depression could also reduce fatigue. METHODS: We report on a double-blind clinical trial of 94 female breast cancerpatients receiving at least four cycles of chemotherapy randomly assigned to receive either 20 mg of the selective serotonin re-uptake inhibitor (SSRI) paroxetine (Paxil, SmithKline Beecham Pharmaceuticals) or an identical-appearing placebo. Patients began their study medication seven days following their first on-study treatment and continued until seven days following their fourth on-study treatment. Seven days after each treatment, participants completed questionnaires measuring fatigue (Multidimensional Assessment of Fatigue, Profile of Mood States-Fatigue/Inertia subscale and Fatigue Symptom Checklist) and depression (Profile of Mood States-Depression subscale [POMS-DD] and Center for Epidemiologic Studies-Depression [CES-D]). RESULTS: Repeated-measures ANOVAs, after controlling for baseline measures, showed that paroxetine was more effective than placebo in reducing depression during chemotherapy as measured by the CES-D (p = 0.006) and the POMS-DD (p = 0.07) but not in reducing fatigue (all measures, ps > 0.27). CONCLUSIONS: Although depression was significantly reduced in the 44 patients receiving paroxetine compared to the 50 patients receiving placebo, indicating that a biologically active dose was used, no significant differences between groups on any of the measures of fatigued were observed. Results suggest that modulation of serotonin may not be a primary mechanism of fatigue related to cancer treatment.
Authors: Jennifer M Jones; Karin Olson; Pamela Catton; Charles N Catton; Neil E Fleshner; Monika K Krzyzanowska; David R McCready; Rebecca K S Wong; Haiyan Jiang; Doris Howell Journal: J Cancer Surviv Date: 2015-04-16 Impact factor: 4.442
Authors: Heather S L Jim; Paul B Jacobsen; Kristin M Phillips; Robert M Wenham; William Roberts; Brent J Small Journal: Health Psychol Date: 2013-02-25 Impact factor: 4.267
Authors: Ann M Berger; Kathi Mooney; Amy Alvarez-Perez; William S Breitbart; Kristen M Carpenter; David Cella; Charles Cleeland; Efrat Dotan; Mario A Eisenberger; Carmen P Escalante; Paul B Jacobsen; Catherine Jankowski; Thomas LeBlanc; Jennifer A Ligibel; Elizabeth Trice Loggers; Belinda Mandrell; Barbara A Murphy; Oxana Palesh; William F Pirl; Steven C Plaxe; Michelle B Riba; Hope S Rugo; Carolina Salvador; Lynne I Wagner; Nina D Wagner-Johnston; Finly J Zachariah; Mary Anne Bergman; Courtney Smith Journal: J Natl Compr Canc Netw Date: 2015-08 Impact factor: 11.908
Authors: Kathleen Meeske; Ashley Wilder Smith; Catherine M Alfano; Bonnie A McGregor; Anne McTiernan; Kathy B Baumgartner; Kathleen E Malone; Bryce B Reeve; Rachel Ballard-Barbash; Leslie Bernstein Journal: Qual Life Res Date: 2007-04-25 Impact factor: 4.147