Adverse Effects and Safety of Antidepressants and Psychedelics for Depression in Cancer: A Systematic Review of Randomized Controlled Trials
Renan Massanobu Maekawa, L. T. L. Guerra, José Carlos Bouso, J. Hallak, R. G. Dos Santos
Psychoactives March 4, 2025 DOI: 10.3390/psychoactives4010006 (opens in new tab) via Semantic Scholar
Summary
AI-generated from the abstractDepression is common in cancer patients but hard to diagnose because its symptoms overlap with those of cancer and its treatments. Treating depression is also complicated by confusion between side effects of antidepressants, cancer therapies, and the disease itself. This systematic review of 21 randomized controlled trials found that serious adverse events from antidepressants were reported in only two studies, suggesting an acceptable safety profile. Most other side effects were mild to moderate and generally well-tolerated. However, small sample sizes highlight the need for larger, placebo-controlled trials to better assess the safety of antidepressants and psychedelics in this population.
Study at a glance
| Characteristics | Systematic review Randomized Placebo-controlled Double-blind Peer reviewed |
|---|---|
| Population | Cancer patients with depressive symptoms |
| Keywords | Medicine |
| Key finding | Serious adverse events from antidepressants were reported in only two studies, indicating an acceptable safety profile, but small sample sizes underscore the need for larger placebo-controlled trials. |
Abstract
Depression is common among patients suffering from cancer, but is often challenging to diagnose due to the overlap of symptoms with cancer and its treatments. Additionally, treating depression in cancer patients is challenging because of the confusion between the adverse effects of antidepressants, cancer treatments, and cancer symptoms. This study aims to evaluate the safety and adverse effects of pharmacological interventions, focusing on antidepressants and psychedelics, in the treatment of depression in cancer patients. The review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, and includes studies published up to July 2024. We searched PubMed, Scielo, and Lilacs databases, and included randomized, double-blinded, controlled clinical trials involving cancer patients with depressive symptoms. A total of 1764 articles were identified, with 21 randomized controlled trials meeting the inclusion criteria. All studies involved cancer patients with depressive symptoms, and only one study included patients with other life-threatening conditions. Serious adverse events related to antidepressant treatment were reported in only two studies, indicating an acceptable safety profile. Most other adverse effects were mild to moderate, and generally well-tolerated. Serious adverse events were infrequent; however, the small sample sizes underscore the necessity of larger, placebo-controlled trials assessing the safety of antidepressants and psychedelics in cancer patients.