Paroxetine in the treatment of depressed patients with haematological malignancy: an open-label study.
The efficacy and tolerability of paroxetine in the treatment of depressive disorders is well known, however, its efficacy and safety for the treatment of depression in patients with cancer has been poorly studied. Therefore this study was aimed at evaluating the efficacy and tolerability of paroxetine in the treatment of depressed patients with haematological malignancy (HM). Fifty-two patients with major depressive disorder (MDD) based on DSM-IV criteria along with comorbid HM were allotted to an 8 week trial with a flexible-dose regime of paroxetine in combination with their chemotherapy or supportive pharmacotherapy. The treatment response was assessed at baseline, week 2, week 4 and week 8 with the 17-item Hamilton rating scale for depression (HAM-D17), the Montgomery Asberg depression rating scale (MADRS) and the clinical global impression-severity (CGI-S). Side effects were collected with reported adverse events and laboratory tests throughout the study period. 44.2% of 52 patients completed the 8 week trial. Scores on the HAM-D17, MADRS and CGI-s (last observation carried forward, LOCF) at baseline were significantly reduced with a mean reduction of 30.5%, 32.8% and 39.1%, respectively, after 8 weeks treatment with paroxetine. In this preliminary study, paroxetine was found to be effective and moderately tolerated in the treatment of depressed patients with HM, and the present study calls for a controlled study in this field to extend and form a framework on the psychopharmacological data in this field.