{"title":"Efficacy comparison of five antidepressants in treating anxiety and depression in cancer and non-cancer patients.","authors":"Kuan Zhao, Youyang Wang, Qun Liu, Ze Yu, Wei Feng","doi":"10.3389/fnins.2024.1485179","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Cancer patients have a heightened susceptibility to anxiety and depressive disorders, which significantly impact the effectiveness of cancer treatments and long-term quality of life. This study aimed to compare the efficacy of different antidepressants in cancer and non-cancer patients.</p><p><strong>Methods: </strong>A total of 610 patients diagnosed with depressive episodes and/or anxiety disorders were retrospectively included and divided into a cancer group and a non-cancer control group. Antidepressants used included escitalopram, duloxetine, sertraline, venlafaxine, and vortioxetine, combined with trazodone or not. The Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder Questionnaire-7 (GAD-7) scores were used to evaluate the efficacy after 4 weeks and 8 weeks of systematic antidepressants treatment.</p><p><strong>Results: </strong>Compared to the non-cancer group, the cancer group had higher proportions of females, older individuals, and patients with poor sleep quality, while reporting fewer somatic symptoms at baseline (all <i>p</i> < 0.05). PHQ-9 and GAD-7 scores in cancer patients treated with antidepressants were significantly lower than baseline at week 4 and week 8 (all <i>p</i> < 0.05). The sertraline group demonstrated significantly less improvement in GAD-7 scores at week 4 and in both GAD-7 and PHQ-9 scores at week 8 compared to the escitalopram group, while duloxetine, venlafaxine, and vortioxetine showed comparable efficacy to escitalopram. Antidepressants combined with trazodone showed significant improvement in PHQ-9 scores at week 4 compared to those without trazodone. The gynecological cancer group showed significantly more improvement in GAD-7 and PHQ-9 scores at week 4 and 8 compared to breast cancer patients.</p><p><strong>Conclusion: </strong>Antidepressant treatment in cancer patients with anxiety and depression is as effective as in non-cancer patients. The efficacy of escitalopram is comparable to duloxetine, venlafaxine, and vortioxetine, all of which outperformed sertraline in cancer patients.</p>","PeriodicalId":12639,"journal":{"name":"Frontiers in Neuroscience","volume":null,"pages":null},"PeriodicalIF":3.2000,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557551/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Neuroscience","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fnins.2024.1485179","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"NEUROSCIENCES","Score":null,"Total":0}
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Abstract
Introduction: Cancer patients have a heightened susceptibility to anxiety and depressive disorders, which significantly impact the effectiveness of cancer treatments and long-term quality of life. This study aimed to compare the efficacy of different antidepressants in cancer and non-cancer patients.
Methods: A total of 610 patients diagnosed with depressive episodes and/or anxiety disorders were retrospectively included and divided into a cancer group and a non-cancer control group. Antidepressants used included escitalopram, duloxetine, sertraline, venlafaxine, and vortioxetine, combined with trazodone or not. The Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder Questionnaire-7 (GAD-7) scores were used to evaluate the efficacy after 4 weeks and 8 weeks of systematic antidepressants treatment.
Results: Compared to the non-cancer group, the cancer group had higher proportions of females, older individuals, and patients with poor sleep quality, while reporting fewer somatic symptoms at baseline (all p < 0.05). PHQ-9 and GAD-7 scores in cancer patients treated with antidepressants were significantly lower than baseline at week 4 and week 8 (all p < 0.05). The sertraline group demonstrated significantly less improvement in GAD-7 scores at week 4 and in both GAD-7 and PHQ-9 scores at week 8 compared to the escitalopram group, while duloxetine, venlafaxine, and vortioxetine showed comparable efficacy to escitalopram. Antidepressants combined with trazodone showed significant improvement in PHQ-9 scores at week 4 compared to those without trazodone. The gynecological cancer group showed significantly more improvement in GAD-7 and PHQ-9 scores at week 4 and 8 compared to breast cancer patients.
Conclusion: Antidepressant treatment in cancer patients with anxiety and depression is as effective as in non-cancer patients. The efficacy of escitalopram is comparable to duloxetine, venlafaxine, and vortioxetine, all of which outperformed sertraline in cancer patients.
简介癌症患者更容易患焦虑症和抑郁症，这严重影响了癌症治疗的效果和长期生活质量。本研究旨在比较不同抗抑郁药对癌症和非癌症患者的疗效：方法：研究人员回顾性地纳入了610名被诊断为抑郁发作和/或焦虑症的患者，并将其分为癌症组和非癌症对照组。使用的抗抑郁药物包括艾司西酞普兰、度洛西汀、舍曲林、文拉法辛和伏替西汀，是否与曲唑酮合用。患者健康问卷-9（PHQ-9）和广泛性焦虑症问卷-7（GAD-7）评分用于评估系统抗抑郁药物治疗4周和8周后的疗效：与非癌症组相比，癌症组中女性、老年人和睡眠质量差的患者比例较高，而基线时报告的躯体症状较少（均 p < 0.05）。接受抗抑郁药物治疗的癌症患者在第4周和第8周的PHQ-9和GAD-7评分明显低于基线（均为P＜0.05）。与艾司西酞普兰组相比，舍曲林组在第4周的GAD-7评分以及第8周的GAD-7和PHQ-9评分的改善程度明显较低，而度洛西汀、文拉法辛和伏替西汀的疗效与艾司西酞普兰相当。与不使用曲唑酮的抗抑郁药相比，联合使用曲唑酮的抗抑郁药在第4周的PHQ-9评分有显著改善。与乳腺癌患者相比，妇科癌症组患者在第4周和第8周的GAD-7和PHQ-9评分有明显改善：结论：对患有焦虑症和抑郁症的癌症患者进行抗抑郁治疗与对非癌症患者进行抗抑郁治疗一样有效。艾司西酞普兰的疗效与度洛西汀、文拉法辛和伏替西汀相当，它们在癌症患者中的疗效均优于舍曲林。
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