Hou J, Li J, Hao ZY, Li YE, Zhang RX, Gong JK, Zhang WJ. Antidepressant-opioid combination for advanced cancer pain-depression comorbidity: Analysis of efficacy and associated determinants. World J Psychiatry 2026; 16(7): 116335 [DOI: 10.5498/wjp.116335]
Corresponding Author of This Article
Wen-Jing Zhang, MD, Department of Pharmacy, Shanxi Province Cancer Hospital, Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences, Cancer Hospital Affiliated to Shanxi Medical University, No. 3 Zhigongxincun Street, Xinghualing District, Taiyuan 030013, Shanxi Province, China. sxszlyyzwj@163.com
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Psychology
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Hou J, Li J, Hao ZY, Li YE, Zhang RX, Gong JK, Zhang WJ. Antidepressant-opioid combination for advanced cancer pain-depression comorbidity: Analysis of efficacy and associated determinants. World J Psychiatry 2026; 16(7): 116335 [DOI: 10.5498/wjp.116335]
World J Psychiatry. Jul 19, 2026; 16(7): 116335 Published online Jul 19, 2026. doi: 10.5498/wjp.116335
Antidepressant-opioid combination for advanced cancer pain-depression comorbidity: Analysis of efficacy and associated determinants
Jie Hou, Jun Li, Zhi-Ying Hao, Yun-E Li, Rui-Xue Zhang, Jiang-Kai Gong, Wen-Jing Zhang
Jie Hou, Jun Li, Zhi-Ying Hao, Yun-E Li, Rui-Xue Zhang, Jiang-Kai Gong, Wen-Jing Zhang, Department of Pharmacy, Shanxi Province Cancer Hospital, Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences, Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan 030013, Shanxi Province, China
Author contributions: Hou J designed the research and wrote the first manuscript; Hou J, Li J, Hao ZY, Li YE, Zhang RX, and Gong JK contributed to conceiving the research and analyzing data; Hou J and Zhang WJ conducted the analysis and provided guidance for the research; all authors reviewed and approved the final manuscript.
Supported by Scientific Research Project Plan of Shanxi Provincial Health Commission, No. 2025ZD111.
Institutional review board statement: This retrospective study was approved by the Ethics Committee of Shanxi Province Cancer Hospital.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: No additional data are available.
Corresponding author: Wen-Jing Zhang, MD, Department of Pharmacy, Shanxi Province Cancer Hospital, Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences, Cancer Hospital Affiliated to Shanxi Medical University, No. 3 Zhigongxincun Street, Xinghualing District, Taiyuan 030013, Shanxi Province, China. sxszlyyzwj@163.com
Received: January 9, 2026 Revised: February 26, 2026 Accepted: April 9, 2026 Published online: July 19, 2026 Processing time: 169 Days and 10.8 Hours
Abstract
BACKGROUND
Cancer pain-depression comorbidity is common in patients with advanced cancer, which may aggravate the disease condition and hinder improvements in physical and mental health.
AIM
To elucidate the performance and associated determinants of an antidepressant-opioid combination in advanced cancer pain (aCP)-depression comorbidity.
METHODS
A total of 199 patients with aCP + depression, admitted between January 2021 and January 2025, were selected for retrospective analysis. Ninety-two cases received opioids (oxycodone extended-release tablets; control group), while 107 cases (observation group) were treated with antidepressants + opioids (duloxetine + oxycodone extended-release tablets). Therapeutic effectiveness, pain status (cancer pain frequency, Numeric Rating Scale), adverse mood (Self-Rating Depression Scale, Self-Rating Anxiety Scale), oxycodone dosages, β-endorphin levels, sleep quality (Pittsburgh Sleep Quality Index), and life quality (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30) were assessed. Univariate and multivariate analyses were conducted to determine efficacy determinants.
RESULTS
Compared with the control group, the observation group demonstrated superior overall therapeutic effectiveness and reduced oxycodone dosing. More pronounced reductions in cancer pain frequency, Numeric Rating Scale, Self-Rating Depression Scale, Self-Rating Anxiety Scale, and Pittsburgh Sleep Quality Index, as well as greater increases in β-endorphin levels and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 scores (all dimensions), were observed in patients with combination therapy compared with those receiving opioids alone.
CONCLUSION
Duloxetine and oxycodone extended-release tablets demonstrates efficacy in treating patients with aCP and depression, achieving effective cancer pain control and mitigation of adverse mood.
Core Tip: To alleviate cancer pain and depression in patients with advanced cancer, this study evaluates the efficacy and determinants of antidepressants (duloxetine) plus opioids (oxycodone extended-release tablets) in treating advanced cancer pain-depression comorbidity. Through several analyses and verifications, the proposed combination regimen was found to effectively relieve pain, mitigate negative emotions, reduce oxycodone dependence, increase β-endorphin levels, and improve patients’ sleep quality and overall quality of life.
