Prescription patterns for psychotropic drugs in cancer patients; a large population study in the Netherlands

Abstract

A total of 113 887 cancer patients and 121 395 control subjects were included. Cancer patients were significantly more often prescribed psychotropic drugs (adjusted OR: benzodiazepines = 1.70, CI = 1.67-1.74; antidepressants = 1.38, CI = 1.34-1.42; and antipsychotics = 1.70, CI = 1.62-1.77). Lower socio-economic status, immigrant, and premorbid chronic medical conditions were significantly associated with higher risk of psychotropic use. Odds for a new prescription for all three psychotropic drugs were significantly less in the first 3 months after cancer diagnosis than the 3 months before death (benzodiazepine, OR = 0.673, CI = 0.647-0.705; antidepressant, OR = 0.592, CI = 0.544-0.644; antipsychotic, OR = 0.177, CI = 0.165-0.190) CONCLUSIONS: Psychotropic drug prescription is common in cancer patients, starts soon after diagnosis, and increases in the terminal stage. Prescription rates were significantly higher in patients from lower socio-economic group, immigrants, or with premorbid chronic medical condition.

Comparison of Psychotropic Prescriptions between Oncology and Cardiology Inpatients: Result from a Pharmacy Database in a Teaching Hospital in Malaysia

“…The prevalence of antidepressant prescription in cancer patients was about 7.8% in this study, which was much lower than the finding of our previous study based on a database from the Netherlands (Ng et al, 2013a). Again, the low prescription rate could attributed to the under-diagnosis of depression and the high caution level in prescribing psychotropic drugs to cancer patients in the local setting.…”

Antidepressant use and risk of central nervous system metastasis

“…This study also found cancer patients who were prescribed antidepressants were more likely to be younger, female, and have a diabetic, cardiovascular, or pulmonary co-morbid condition [253], while among breast cancer patients in Wisconsin, antidepressant use was more likely among women who were younger, premenopausal, obese, have fewer children, and receive adjuvant therapy in comparison to those women who did not take antidepressants [11]. Interestingly, another study among breast cancer patients found age, education, stage at time of diagnosis, time since diagnosis, or time since last recurrence or metastasis were not associated with antidepressant prescription rates [255].…”

“…Antidepressants are used more frequently in the cancer population in comparison to the general population [10,253]. According to a study conducted in Australia, antidepressant use in the cancer population ranged from 6.2% to 11.7% for the different periods studied, while antidepressant use in individuals without a cancer diagnosis ranged from 4.6% to 7.4% [10].…”

“…In the Netherlands, cancer patients were 38% (95% CI: 34%-42%) more likely to use an antidepressant in comparison to the general population when controlling for age, gender, immigrant status, neighborhood socio-economic status, and pre-morbid chronic medical conditions (diabetic, cardiovascular, and pulmonary conditions) [253]. This study also found cancer patients who were prescribed antidepressants were more likely to be younger, female, and have a diabetic, cardiovascular, or pulmonary co-morbid condition [253], while among breast cancer patients in Wisconsin, antidepressant use was more likely among women who were younger, premenopausal, obese, have fewer children, and receive adjuvant therapy in comparison to those women who did not take antidepressants [11].…”

Psychiatric comorbidity among terminally ill patients in general practice in the Netherlands: a comparison between patients with cancer and heart failure

“…A previous study showed that shortly before dying the chances for prescription of a new psychotropic drug increase. 39 It can now be added that the increased incidence of psychiatric comorbidity and the use of psychotropic drugs are related to the terminal disease phase and are not disease specific.…”