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What type and dose of antidepressants are cancer and non-cancer inpatients being prescribed: a retrospective case-control study at an Australian tertiary hospital

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Abstract

Purpose

Cancer patients are often prescribed antidepressants, but little data is available about whether the type and dose are similar to prescriptions to patients with other chronic diseases. This study compared the prescription practices of antidepressants to cancer and non-cancer inpatients at a major Australian tertiary hospital and assessed side effects and potential drug-drug interactions.

Methods

Inpatients diagnosed with cancer within the past 12 months and prescribed antidepressants were age and gender matched to inpatients with other chronic disease conditions. Data from 75 cancer and 75 non-cancer inpatients were extracted.

Results

Antidepressants were prescribed to cancer and non-cancer patients, respectively, for the treatment of depression (n = 50 vs n = 59), other mental health problems (n = 8 vs n = 11, p < 0.67) or unspecified reasons (n = 17 vs n = 5, p < 0.02). Mirtazapine (n = 11/75) was most commonly prescribed to cancer patients followed by duloxetine (n = 9/75). Desvenlafaxine (n = 15/75) was prescribed most commonly to non-cancer inpatients, followed by mirtazapine (n = 11/75). Four cancer patients and three non-cancer patients had documented adverse side effects from antidepressants. About one-third of cancer patients (n = 23/75) and about a quarter of non-cancer patients (n = 18/75) were prescribed other medicines with the potential for drug-drug interactions with antidepressants.

Conclusions

Antidepressants were prescribed for a range of indications in all patients, but more commonly for unspecified reasons among the cancer patients. Future prospective studies that monitor antidepressant prescribing to cancer patients should ascertain details of the indication, pathways to prescription and differences in type, dose or schedule depending on prescribing medical practitioner.

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Acknowledgements

We would like to thank the Department of Pharmacy, Royal Brisbane and Women’s Hospital for support of this research. Professor Monika Janda was funded by NHMRC Career Development Fellowship 1045247.

Author information

Authors and Affiliations

  1. School of Public Health and Social Work, Institute for Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD, 4059, Australia

    Saira Sanjida & Monika Janda

  2. Department of Pharmacy, Royal Brisbane and Women’s Hospital, Brisbane, Australia

    Kelly Mulvogue

  3. Psycho-oncology Co-operative Research Group, School of Psychology, The University of Sydney, Sydney, Australia

    Joanne Shaw & Melanie A. Price

  4. Mental Health, Justice Health, Alcohol and Drug Services, ACT Health, Canberra, Australia

    Jeremy Couper

  5. Department of Psychiatry, Monash University, Melbourne, Australia

    David Kissane

  6. Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia

    Sallie-Anne Pearson

Authors
  1. Saira Sanjida
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Corresponding author

Correspondence to Monika Janda.

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Ethics approval

For this type of study (retrospective chart review), formal consent was not required. The study was approved by the Royal Brisbane Women’s Hospital (EC00172) and Queensland University of Technology (1500000417) human research ethics committees.

Competing interests

The authors declare that they have no competing interests.

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Sanjida, S., Mulvogue, K., Shaw, J. et al. What type and dose of antidepressants are cancer and non-cancer inpatients being prescribed: a retrospective case-control study at an Australian tertiary hospital. Support Care Cancer 26, 625–634 (2018). https://doi.org/10.1007/s00520-017-3876-4

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