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Preventing Fatigue in Patients With Breast Cancer Treated with Chemotherapy

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Final rept. 23 Sep 1996-23 Mar 2001

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This is the final report on a clinical trial of breast cancer patients designed to test the hypothesis that administering an antidepressant medication during chemotherapy treatment would prevent or alleviate the development of treatment-induced fatigue. We conducted a randomized, double-blind, placebo-controlled clinical trial with 124 breast cancer patients who were studied for up to four successive chemotherapy treatments. Patients were randomized to take the antidepressant paroxetine Paxilregistered or placebo once a day during the trial. They completed measures of fatigue and depression on the 7th day following each of the four chemotherapy cycles. Patient motion was assessed as a concomitant measure of fatigue by ambulatory electronic monitoring during the second and fourth assessments. Contrary to expectations, our findings showed that paroxetine was not helpful in reducing or preventing fatigue in cancer patients undergoing chemotherapy. They did, however, show that paroxetine can reduce depression in cancer patients undergoing chemotherapy, suggesting that depression and fatigue are differentially affected by an SSRI known to modulate brain 5-HT levels. Our findings also provide evidence that the physiologic process of circadian rhythm disruption is involved in the psychological experience of fatigue and depression in cancer patients.

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  • Medicine and Medical Research
  • Pharmacology

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