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Objective To investigate the efficacy and safety of oxycodone sustained-release tablets combined with different types of antidepressants (duloxetine and paroxetine) in the patients suffering from depression and pain due to advanced cancer. Methods A total of 108 depressive patients with advanced cancer pain in admitted in Hubei Third People's Hospital from July 2018 to September 2019 were recruited in this study. They were divided into 3 groups single-blindly and randomly, with 36 subjects in each group. The patients from Group A were given oxycodone sustained-release tablets only, those out of Group B the tablets+paroxetine, and those of Group C the tablets+duloxetine. Pain relief, depression, anxiety, dose of oxycodone, sleep quality, quality of life and adverse reactions were compared among the 3 groups after treatment. Results After treatment of 1 week, the numeric rating scale (NRS) score of Group C was significantly lower than those of Group B and A (P < 0.05). The NRS score and self-rating anxiety scale (SAS) score at 2 weeks after treatment, and the self-rating depression scale (SDS) score at 1 week after treatment were significantly decreased in a trend from Group A to Group B to Group C (all P < 0.05). But there were no obvious differences in the NRS, SAS and SDS scores at 1 and 2 months after treatment, and the SDS score at 2 weeks after treatment between Group C and B (P>0. 05), and all of these scores were notably lower than those of Group A (P < 0. 05). After treatment of 2 months, the average daily oral dose of oxycodone per capita in Group A and B were significantly higher than that before treatment (P < 0.05), but no such difference was seen in Group C (P>0.05). The score of Pittsburgh sleep quality index (PSQI) were remarkably decreased in the 3 groups after treatment (P < 0.05). But no significant differences were seen in the average daily oral dose of oxycodone per capita and the PSQI score between Group B and C, but the dose and score were both significantly lower than those of Group A (P < 0.05). In 2 months after treatment, the scores of different items of quality of life score were significantly increased in the 3 groups (P < 0.05), but except for the role function score, there were no differences in other scores between Group C and B (P>0.05), and the scores were significantly higher than those of Group A (P < 0.05). After treatment of 2 months, the adverse reactions had no significant differences among the 3 groups (P>0.05), and were gradually reduced or disappeared after symptomatic treatment or dose adjustment. Conclusion In the treatment of depressive patients with pain from advanced cancer, oxycodone sustained-release tablets combined with duloxetine is superior to paroxetine in quick onset, effective improvement of pain, depression, anxiety and quality of sleep and life, and reduced dose of oxycodone, and does not increase adverse reactions. |
