Depression in palliative care: a systematic review. Part 2. Treatment

Abstract: Objective: To summarize available literature containing data on the treatment of depression in palliative care patients. Methods: A systematic review was conducted using extensive electronic databases and hand searches. All randomized controlled trials (RCTs) of interventions for depression in patients with advanced disease were eligible. Results: Three RCTs assessed pharmacological treatments. Of these, two were placebo controlled and assessed mianserin and thioridazine. The third compared two antidepressants. There were no RCTs that specifically assessed psychotherapy for patients with depression. Conclusion: There are too few adequate studies to draw clear conclusions about management of depression in this setting. The treatment of depression in patients with advanced disease must, for now, be informed by the larger body of evidence on effective treatments for depression in patients with either no physical illness or less severe medical conditions. PalliativeMedicine 2002; 16: 279 ± 284 Key words: advanced cancer; depression; depressive disorder; intervention; palliative care; treatmen