Sarkar, S., & Schaefer, M. (2014). Antidepressant pretreatment for the prevention of interferon alfa-associated depression: A systematic review and meta-analysis. Psychosomatics, 55, 221–234.
DOI Link
Purpose
STUDY PURPOSE: To assess whether pre-emptive antidepressants can reduce the incidence and severity of depression associated with interferon alpha
TYPE OF STUDY: Meta-analysis and systematic review
Search Strategy
DATABASES USED: PubMed, EMBASE, PsycINFO, and Cochrane
KEYWORDS: depress or MDD and prevention or prophylaxis and interferon and antidepressants
INCLUSION CRITERIA: Prospective controlled trials (RCTs), using interferon as monotherapy. Antidepressant administered before initiating interferon and for at least 12 weeks during treatment. Depression evaluated by DSM-IV criteria
EXCLUSION CRITERIA: Case series and retrospective studies
Literature Evaluated
TOTAL REFERENCES RETRIEVED: 120
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: No evaluation described for quality
Sample Characteristics
- FINAL NUMBER STUDIES INCLUDED = 8
- TOTAL PATIENTS INCLUDED IN REVIEW = 589
- SAMPLE RANGE ACROSS STUDIES: 33–181
- KEY SAMPLE CHARACTERISTICS: Included patients with hepatitis C. One study in melanoma
Phase of Care and Clinical Applications
PHASE OF CARE: Active antitumor treatment
Results
Analysis showed that antidepressant treatment reduced overall incidence of depressive disorder (OR = 0.42, p < 0.001). Only one trial was done in which patients with a history of depression were excluded.
Conclusions
Prophylactic use of antidepressants was associated with reduced incidence of depression in patients receiving interferon alpha monotherapy.
Limitations
- There was only one study in patients with cancer.
Nursing Implications
Depression has been identified as an adverse effect of treatment with interferon alpha. This study showed that pre-emptive treatment with antidepressants can reduce the incidence of this effect. Nurses need to be aware of depression associated with interferon alpha treatment, and assess patients for depression, especially if they have a history of depressive symptoms. Long-term effects in patients with cancer are unknown, since there is limited evidence for this group of patients.
Legacy ID
5704