Effect of paroxetine hydrochloride (Paxil®) on fatigue and depression in breast cancer patients receiving chemotherapy
Effect of paroxetine hydrochloride (Paxil®) on fatigue and depression in breast cancer patients receiving chemotherapy
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DOI：
10.1007/s10549-004-2175-1
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发表时间：
2005-02-01
影响因子：
3.8
通讯作者：
Smith, B
中科院分区：
文献类型：
--
作者：
Roscoe, JA;Morrow, GR;Smith, B
背景。疲劳会严重影响癌症患者履行日常责任和享受生活的能力。在接受化疗的患者中，它通常与抑郁症共存，这表明服用减轻抑郁症症状的抗抑郁药也可以减轻疲劳。我们报告了一项双盲临床试验，94名女性乳腺癌患者接受至少四个周期的化疗，随机分配接受20毫克选择性5 -羟色胺再摄取抑制剂（SSRI）帕罗西汀（Paxil(R)， SmithKline Beecham制药公司）或相同外观的安慰剂。患者在第一次研究治疗后7天开始研究用药，并持续到第4次研究治疗后7天。每次治疗后7天，参与者完成疲劳问卷（多维疲劳评估、情绪状态量表-疲劳/惯性量表和疲劳症状检查表）和抑郁问卷（情绪状态量表-抑郁量表[POMS-DD]和流行病学研究中心-抑郁量表[CES-D]）。在控制基线测量后，重复测量的方差分析显示，通过ses - d （p = 0.006）和POMS-DD （p = 0.07）测量，帕罗西汀在减轻化疗期间的抑郁方面比安慰剂更有效，但在减轻疲劳方面没有效果（所有测量，ps > 0.27）。尽管44名接受帕罗西汀治疗的患者与50名接受安慰剂治疗的患者相比，抑郁症明显减少，这表明使用了生物活性剂量，但在任何疲劳测量指标上，两组之间没有明显差异。结果表明，调节血清素可能不是癌症治疗相关疲劳的主要机制。
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 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 cancer patients receiving at least four cycles of chemotherapy randomly assigned to receive either 20 mg of the selective serotonin re-uptake inhibitor (SSRI) paroxetine (Paxil(R), 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.