Effect of Mirtazapine on Improving the Quality of Life in Breast Cancer Patients
Keywords:
depresión, cáncer, calidad de vida, mirtazapinaAbstract
Introduction: Mirtazapine is an antidepressant drug with serotonergic and noradrenergic effects, which is used to treat various cancer symptoms.
Objective: Describe the effect of Mirtazapine medication on improving the quality of life in breast cancer patients, in Sabzevar, Iran.
Methods: This study was conducted as a randomized controlled clinical trial on two groups of breast cancer patients referred to the chemotherapy and radiotherapy center at Vasei Educational Hospital in Sabzevar, Iran, in 2022. After random assignment, the research had 55 patients in the intervention group (Mirtazapine) and 55 in the control group. The intervention group received Mirtazapine medication for 8 weeks under the supervision of a psychiatrist, at a daily dose of 15-30 milligrams. After 8 weeks, all patients were asked to complete a quality-of-life questionnaire again. The data was analyzed using SPSS 24 software and a t-test, and chi-square test, with a significance level of 0.05.
Results: The average age of the patients was 54.05±12.91. The two groups were homogeneous in all quantitative and qualitative variables before the intervention, and there was no significant statistical difference (p > 0.05).
The comparison of the average variables in the two groups in the field of quality of life after intervention has been reported to be significant (P = 0.008). Moreover, this comparison in the field of general health after intervention between the two research groups was not significant (p = 0.779). The use of Mirtazapine medication in cancer patients significantly improved sleep quality and sexual relationships, and improved their sexual function, mood, sadness, anxiety, and depression (p <0.001).
Conclusion: A recent study showed that using Mirtazapine medication in cancer patients enhances sleep quality, satisfaction in sexual relationships, mood, depression, and anxiety symptoms, and overall quality of life without affecting the general health subscale.
Downloads
References
2. Trayes KP, Cokenakes SE. Breast cancer treatment. American Family Physician 2021:104(2): 171-178.
3. Burguin A, Diorio C, Durocher F. Breast cancer treatments: Updates and new challenges. Journal of personalized medicine 2021:11(8): 808.
4. Alquraan L, Alzoubi KH, Rababa’h S, Karasneh R, Al-Azzam S, Al-Azayzih A. Prevalence of depression and the quality-of-life of breast cancer patients in Jordan. Journal of Multidisciplinary Healthcare 2020: 1455-1462.
5. Hashemi S-M, Rafiemanesh H, Aghamohammadi T, Badakhsh M, Amirshahi M, Sari M, Behnamfar N, Roudini K. Prevalence of anxiety among breast cancer patients: A systematic review and meta-analysis. Breast Cancer 2020:27(166-178.
6. Pilevarzadeh M, Amirshahi M, Afsargharehbagh R, Rafiemanesh H, Hashemi S-M, Balouchi A. Global prevalence of depression among breast cancer patients: A systematic review and meta-analysis. Breast cancer research and treatment 2019:176(519-533.
7. Economos G, Lovell N, Johnston A, Higginson IJ. What is the evidence for mirtazapine in treating cancer-related symptomatology? A systematic review. Supportive Care in Cancer 2020:28(1597-1606.
8. de Queiroz Oliveira T, de Sousa CNS, Vasconcelos GS, de Sousa LC, de Oliveira AA, Patrocínio CFV, da Silva Medeiros I, Júnior JERH, Maes M, Macedo D. Brain antioxidant effect of mirtazapine and reversal of sedation by its combination with alpha-lipoic acid in a model of depression induced by corticosterone. Journal of Affective Disorders 2017:219(49-57.
9. Biswas PN, Wilton LV, Shakir SA. The pharmacovigilance of mirtazapine: Results of a prescription event monitoring study on 13 554 patients in england. Journal of Psychopharmacology 2003:17(1): 121-126.
10. Kraus T, Haack M, Schuld A, Hinze-Selch D, Koethe D, Pollmächer T. Body weight, the tumor necrosis factor system, and leptin production during treatment with mirtazapine or venlafaxine. Pharmacopsychiatry 2002:35(06): 220-225.
11. White H, Sabarwal S. Quasi-experimental design and methods. Methodological briefs: impact evaluation 2014:8(2014): 1-16.
12. de Souza CCC, Zacarias LC, Campos NG, Fortaleza SCB, Madeira CA, Sousa Almondes JGd, Leite CF. Validation of the world health organization disability assessment schedule (whodas 2.0) for individuals with asthma. Disability and Rehabilitation 2024: 1-8.
13. Cankurtaran ES, Ozalp E, Soygur H, Akbiyik DI, Turhan L, Alkis N. Mirtazapine improves sleep and lowers anxiety and depression in cancer patients: Superiority over imipramine. Supportive care in cancer 2008:16(11): 1291-1298.
14. Kim S-W, Shin I-S, Kim J-M, Kim Y-C, Kim K-S, Kim K-M, Yang S-J, Yoon J-S. Effectiveness of mirtazapine for nausea and insomnia in cancer patients with depression. Psychiatry and clinical neurosciences 2008:62(1): 75-83.
15. Chaves C, Zandonadi RP, Raposo A, Nakano EY, Ramos F, Farage P, Teixeira-Lemos E. Health-related quality of life among celiacs in Portugal: A comparison between general and specific questionnaires. Frontiers in Immunology 2024:15(3): 1-9.
16. Calvo‐Torres J, Rejas‐Gutiérrez J, Ramírez‐Mena M, Bradbury M, Del Pino M, González‐Granados C, Procas B, Coronado PJ, group HQs. Population‐based norms for the human papillomavirus‐quality of life (hpv‐qol) questionnaire: A cross‐sectional multicenter study. Acta Obstetricia et Gynecologica Scandinavica 2024.
17. Coronado PJ, González-Granados C, Ramírez-Mena M, Calvo J, Fasero M, Bellón M, García-Santos JF, Rejas-Gutiérrez J. Development and psychometric properties of the human papillomavirus-quality of life (hpv-qol) questionnaire to assess the impact of hpv on women health-related-quality-of-life. Archives of Gynecology and Obstetrics 2022:306(4): 1085-1100.
18. Taavela K, Eriksson T, Huhtala H, Bly A, Harjula K, Heikkilä K, Hokkanen M, Nummela M, Kotaniemi-Talonen L, Lehtinen M. The quality of life of frequently vs. Infrequently screened hpv vaccinated women. Quality of Life Research 2024:33(4): 941-949.
19. Economos G, Alexandre M, Perceau-Chambard E, Villeneuve L, Subtil F, Haesebaert J, Glehen O. What is the effectiveness and safety of mirtazapine versus escitalopram in alleviating cancer-associated poly-symptomatology (the mir-p study)? A mixed-method randomized controlled trial protocol. BMC Palliative Care 2022:21(1): 1-9.
20. Zaini S, Ng C, Sulaiman AH, Huri N, Shamsudin SH. A review of the use of mirtazapine in cancer patients. Malaysian Journal of Psychiatry 2017:25(2): 58-68.
21. Ersoy MA, Noyan AM, Elbi H. An open-label long-term naturalistic study of mirtazapine treatment for depression in cancer patients. Clinical drug investigation 2008:28(2): 113-120.
22. Davis MP, Khawam E, Pozuelo L, Lagman R. Management of symptons associated with advanced cancer: Olanzapine and mirtazapine. Expert review of anticancer therapy 2002:2(4): 365-376.
23. Theobald DE, Kirsh KL, Holtsclaw E, Donaghy K, Passik SD. An open-label, crossover trial of mirtazapine (15 and 30 mg) in cancer patients with pain and other distressing symptoms. Journal of pain and symptom management 2002:23(5): 442-447.