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.
Department of Pharmacy, Royal Brisbane and Women's Hospital, Brisbane, Australia.
Support Care Cancer. 2018 Feb;26(2):625-634. doi: 10.1007/s00520-017-3876-4. Epub 2017 Sep 19.
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.
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.
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.
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.
癌症患者经常被开具抗抑郁药，但关于癌症患者与其他慢性病患者的处方类型和剂量是否相似的数据很少。本研究比较了澳大利亚一家主要的三级医院癌症和非癌症住院患者的抗抑郁药处方情况，并评估了副作用和潜在的药物相互作用。
在过去 12 个月内被诊断患有癌症并开具抗抑郁药的住院患者按年龄和性别与患有其他慢性疾病的住院患者相匹配。共提取了 75 名癌症和 75 名非癌症住院患者的数据。
癌症和非癌症患者分别因以下原因开具抗抑郁药：治疗抑郁症（n=50 对 n=59）、其他心理健康问题（n=8 对 n=11，p<0.67）或未指定原因（n=17 对 n=5，p<0.02）。米氮平（n=11/75）是最常用于治疗癌症患者的药物，其次是度洛西汀（n=9/75）。文拉法辛（n=15/75）是最常用于治疗非癌症住院患者的药物，其次是米氮平（n=11/75）。有 4 名癌症患者和 3 名非癌症患者记录到抗抑郁药的不良反应。约三分之一的癌症患者（n=23/75）和大约四分之一的非癌症患者（n=18/75）同时开具了其他具有与抗抑郁药发生药物相互作用潜力的药物。
所有患者都开具了各种适应症的抗抑郁药，但癌症患者中更多地是因未指定原因而开具。未来监测癌症患者抗抑郁药处方的前瞻性研究应确定适应症、处方途径以及根据开处方的医生的不同而在药物类型、剂量或方案方面的差异的详细信息。
