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Pharmacological treatment of depression in patients with a primary brain tumour

  • Review
  • Intervention

Authors

  • Alasdair Rooney,

    Corresponding author
    1. Western General Hospital, Edinburgh Centre for Neuro-Oncology (ECNO), Edinburgh, Scotland, UK
    • Alasdair Rooney, Edinburgh Centre for Neuro-Oncology (ECNO), Western General Hospital, Crewe Road, Edinburgh, Scotland, EH4 2XU, UK. a.rooney@nhs.net.

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  • Robert Grant

    1. Western General Hospital, Clinical Neurosciences, Bramwell Dott Building, Edinburgh, UK
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Abstract

Background

Patients with a primary brain tumour often experience depression, for which drug treatment may be prescribed. However, these patients are also at high risk of epileptic seizures, cognitive impairment and fatigue, all of which are potential side-effects of antidepressants. The benefit, or harm, of pharmacological treatment of depression in brain tumour patients is unclear.

Objectives

To assess the benefits and harms of pharmacological treatment of depression in patients with a primary brain tumour.

Search methods

We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2009, Issue 3), MEDLINE (1950 to July 2009) and EMBASE (1980 to July 2009). We searched PsycINFO, the British Nursing Index, LILACS, Psyndex, the NHS National Research Register, the NHS Centre for Reviews and Disseminations' Database of Abstracts of Reviews of Effectiveness (DARE) and Web of Knowledge (covering Science Scisearch, Social Sciences Citation Index and Biological Abstracts) (up to July 2009). We handsearched Neuro-oncology, the Journal of Neuro-oncology, the Journal of Neurology, Neurosurgery and Psychiatry and the Journal of Clinical Oncology (July 1999 to June 2009) and wrote to all the pharmaceutical companies manufacturing antidepressants for use in the UK.

Selection criteria

We included all randomised controlled trials (RCTs), controlled clinical trials, cohort studies and case-control studies of any pharmacological treatment of depression in patients with a histologically diagnosed primary brain tumour.

Data collection and analysis

No studies met the inclusion criteria for this review.

Main results

We found no eligible studies evaluating the benefits or harms of any pharmacological treatment of depression in brain tumour patients suffering from depression.

Authors' conclusions

No high-quality studies have examined the value of any drug treatment of depression in patients with primary brain tumours. Detailed prospective studies and RCTs are needed to inform the safe and effective treatment of this common and important complication of brain tumours.

Plain language summary

Pharmacological treatment of depression in patients with a primary brain tumour

People with brain tumours may experience epilepsy, memory problems and fatigue. Depression is also common and doctors might choose to treat this with antidepressants, since antidepressants are thought to be effective in other patients. However, antidepressants could be less effective, or could cause more side-effects, in patients with brain tumours.

The review authors researched whether any drugs have been proven to be effective, and whether they cause significant side-effects when prescribed to treat depression in patients with brain tumours. They searched the medical journal literature to find high-quality studies comparing the effectiveness of any one drug treatment for depression in patients with a brain tumour against another treatment. They also tried to find studies describing the side-effects of any such treatment. Despite a thorough search, the authors could not find any studies and so cannot make an informed decision as to whether any drug is of any benefit, or harm. The review authors conclude that it is important to research whether drugs can treat depression safely and effectively in people with brain tumours.

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