Paxil eases depression but not fatigue in patients getting chemotherapy

A commonly used antidepressant significantly relieves depression in cancer patients undergoing chemotherapy, but has less effect on fatigue, according to a study led by University of Rochester Medical Center researcher Gary Morrow, Ph.D.

Results of the study, sponsored by the National Cancer Institute and conducted by community physicians nationwide, suggest that fatigue in these patients may be more related to a patient�s cancer and its treatment, rather than depression. Morrow will present the results Monday at the annual meeting of the American Society of Clinical Oncology in San Francisco.

Previous studies in the general population and several surveys of cancer patients have associated depression with increased fatigue, and animal models of low serotonin levels have also demonstrated a common link. But, in this study, researchers found that while Paxil significantly alleviated depression, the drug�s effect on fatigue was not significant.

�Our results show that depression and fatigue do not seem as closely related in cancer patients as we once thought, especially in patients receiving chemotherapy,� said Morrow, a professor of radiation oncology and psychiatry. �This study demonstrates we can successfully treat depression in cancer patients, but an effective intervention for fatigue remains to be shown.�

In the double-blind study funded by the National Cancer Institute, 738 patients being treated in 18 different private medical oncology practices affiliated with the Community Clinical Oncology Program Research Base at the University of Rochester Medical Center were assigned to receive either a 20 mg daily dose of paroxetine hydrochloride (Paxil), a selective serotonin re-uptake inhibitor, or a placebo. Patients were then asked to fill out questionnaires on mood and functioning.

Depression is associated with a decreased amount of serotonin in the brain, which helps regulate mood. Paxil blocks the reabsorption of serotonin and normalizes the brain's chemical supply.

According to Morrow, �Up to half of cancer patients may experience some degree of depression during the course of their diagnosis, treatment and recovery, and the condition has not been optimally treated. We found that it can be successfully treated by medical oncologists who treat patients in the community.�