Assessment of Antidepressant Prescription Patterns in Cancer Patients: A Single-center Observational Study

Depression and other psychological disorders significantly affect cancer patients' quality of life and treatment outcomes. Despite this recognition, comprehensive data on antidepressant prescription patterns in cancer care settings throughout the world remain limited. This study aimed to analyze antidepressant prescription patterns among patients with cancer and variations across medical departments, pharmacological effects, clinical symptoms, and treatment modalities.

A retrospective chart review of antidepressant prescriptions was conducted at Chiba Cancer Center between January 1 and December 31, 2022. Patient demographics, primary department visits, types of antidepressants, reasons for prescription, and concurrent cancer treatments were evaluated.

Among 20,440 patients with cancer, 214 (1.1%) received antidepressant prescriptions. The mean age was 63.9±13.0 years, with female patients (61%) receiving prescriptions more frequently than males (39%). The prescription proportions were highest for patients who visited multiple departments (2.7%), those receiving palliative care (1.9%), and those who underwent breast surgery (1.6%). Serotonin-norepinephrine reuptake inhibitors (29%) and serotonin antagonists and reuptake inhibitors (28%) were the most commonly prescribed antidepressants. The primary reasons for prescription were insomnia (38%), pain and numbness (31%), and depression (23%). The majority of prescriptions were initiated during chemotherapy (33%) or surgery (19%).

This study revealed a relatively low proportion of antidepressant prescriptions among patients with cancer compared with previous reports. Prescriptions were more common in female patients and in those receiving care from multiple departments. Physical symptoms, rather than depression, are the primary drivers of antidepressant prescriptions. These findings suggest a need for enhanced psychological assessment and support in cancer care settings.