Antidepressants, well-being and survival in advanced cancer. The ZEST Trial: A double-blind, placebo-controlled trial of Zoloft's Effects on Symptoms and survival Time in Advanced Cancer

Symptoms of depression, anxiety, fatigue and lack of energy are common, important and closely related in people with advanced cancer. Modern antidepressants are highly effective at relieving these symptoms in people WITH clinical depression. This study will determine if a modern antidepressant can improve these symptoms in people with advanced cancer but WITHOUT clinical depression. Patients are randomized to receive either sertraline 50mg daily or placebo. Oncological, psychological, psychiatric, social and other support services are used according to standard best practice at that centre. Participants complete quality of life booklets and are reviewed at months 0, 1, 2, 3, 4, 6, 9, and 12.