Prescribing practices of selective serotonin reuptake inhibitors (SSRIs) among pediatric oncologists: a single institution experience

Although children and adolescents with cancer often experience symptoms of anxiety and depression, there are no published data regarding the use of selective serotonin reuptake inhibitors (SSRIs) for treating depression in the pediatric oncology population. The goal of this study was to characterize SSRI prescribing practices among pediatric oncologists. A brief (14 item) written survey was distributed to all attending and fellow physicians at a large center with an 85% response rate (N = 40). Half of the respondents prescribed SSRIs for patients, and the most common triggers for prescription include oncologist perceptions of the patient's general sadness, major depressive disorder, and anxiety. The majority of oncologists in the sample (70%) used more than one SSRI. Most physicians prescribe during the first year of therapy and 50% feel that their practice will be influenced by the Federal Drug Administration (FDA) warnings governing the use of SSRIs in the pediatric population. Some physicians consult hospital psychologists, while fewer consult psychiatrists prior to prescribing for these patients. The information gathered from this survey demonstrates that pediatric oncologists are prescribing SSRIs for their patients for a variety of indications. Prospective clinical trials that involve screening patients for depression and anxiety prior to and following SSRI therapy may be helpful in determining whether they result in amelioration of symptoms. It would also be important to evaluate the benefits of a concurrent psychological intervention with medication.