The purpose of this study was to investigate the use of psychotropic medication in patients referred to a psycho-oncology service. While depressive disorders and psychological difficulties are being increasingly recognised in oncology patients, the use of psychotropic medication has not been frequently studied, nor has it been studied in patients who are subsequently referred for psychiatric assessment.
The use of psychotropic medication in all patients referred to a psycho-oncology service over a 6-month period was examined prospectively. Details recorded included class of psychotropic medication used and by whom it was prescribed. Demographic details and clinical diagnoses were also recorded.
Sixty-three patients were referred over the initial 6 months of the service and the majority had advanced or metastatic disease (62%). Clinically, 44.5% had some form of major psychiatric disorder, and 40% had an adjustment disorder. Over half (55.5%) were already on psychotropic medication at referral; mainly minor tranquillisers (51%) and antidepressants (24%); 22% were on more than one drug. Of those medications prescribed pre-referral, 46% had been prescribed by the oncology team and 31% were from the GP. Following psychiatric review, further medication was prescribed in 30% of the subjects, leaving a total of 79% on some form of psychotropic drug.
While the overall psychotropic prescribing and the use of minor tranquillisers appears to be similar to those found in earlier studies, the high rate of use of antidepressants suggests psychological distress is being increasingly recognised, and pharmacotherapy is a commonly used strategy in this group.