Antidepressants May Help Head and Neck Cancer Patients

The results of a pilot study conducted at the University of Nebraska Medical Center in Omaha suggest that administration of the antidepressant Celexa (citalopram) during treatment of head and neck cancer reduces depression and may lessen the impact of cancer on quality of life.

Depression has been reported in up to 40% of head and neck cancer patients, "typically within the first 3 months of diagnosis," according to Dr. William M. Lydiatt and colleagues. In an interview with Reuters Health, Dr. Lydiatt added that suicide rates for patients with head and neck cancer are particularly high because this type of cancer affects "the most basic aspects of living, including speech, swallowing, and breathing."

Because most of the treatment for head and neck cancer is completed within a period of 12 weeks, Lydiatt's team conducted their study within that same 12 week time frame, with a final follow-up at 16 weeks.

The team randomly assigned 36 patients to either Celexa or to a placebo. Thirteen patients in the Celexa group and 10 in the placebo group completed the study.

"All measures of psychiatric well-being favored the group taking citalopram," said the report. Of the patients taking Celexa, 15% had "mild" depression symptoms at 16 weeks, compared to 60% in the placebo group who were rated "mild" or worse. In addition, 17% of the Celexa group were diagnosed with major depression at weeks 12 and 16 compared to 50% of the placebo group.

In the placebo group, two patients experienced suicidal thoughts and one was hospitalized for depression. In contrast, none in the Celexa group experienced suicidal thoughts or had to be hospitalized.

Although quality of life declined for both groups, the decline was less for those taking the antidepressant and actually began to improve between weeks 12 and 16 in the Celexa group.

While the authors felt that their findings were "hopeful", they noted that the small size of the study prevented them from making the recommendation to treat all head and neck cancer patients with an antidepressant.

The article was published in Archives of Otolaryngology - Head Neck and Surgery.