title: Changes in the prescription of psychotropic drugs in the palliative care of advanced cancer patients over a seven-year period.
abstract: BACKGROUND
  Psychiatric disorders are frequently underdiagnosed and undertreated in advanced cancer patients.
  
  
  OBJECTIVE
  To assess changes in the prescription of psychotropic drugs in terminally ill patients.
  
  
  METHODS
  All patients with advanced disease receiving palliative care between 2002 and 2009 were eligible. The consumption of benzodiazepines, antipsychotics, and antidepressants for the years 2002, 2006, and 2009 was compared. Data on the percentage and profile of psychotropic drugs prescribed were collected.
  
  
  RESULTS
  The study population included 840 patients (241 in 2002, 274 in 2006, and 325 in 2009). The percentage of patients treated with psychotropic drugs increased from 82.2% in 2002 to 90.2% in 2009 (P = 0.006) and the mean number of drugs per patient from 1.66 in 2002 to 2.16 in 2006 (P = 0.003), and to 2.35 in 2009 (P<0.001). Benzodiazepines were prescribed to 72.6% of patients in 2002 and 84% in 2009 (P = 0.001), with lorazepam and midazolam as the most frequently used medications. The use of antipsychotics increased from 26.1% in 2002 to 37.2% in 2006 (P = 0.007) and to 40% in 2009 (P = 0.001), with haloperidol and risperidone as the most commonly prescribed. Antidepressants were prescribed to 17.8% in 2002, 28.1% in 2006 (P = 0.006), and 27.1% in 2009 (P = 0.010), with mirtazapine, citalopram, escitalopram, and duloxetine as the most frequent.
  
  
  CONCLUSIONS
  Between 2002 and 2009, there was a significant increase in the use of psychotropic drugs and a change in the profile of drugs prescribed.
authors.affiliation: Palliative Care Unit, Division of Medical Oncology, Department of Internal Medicine, Hospital de l'Esperança, Universitat Autónoma de Barcelona, Universitat Pompeu Fabra, Parc de Salut Mar, Barcelona, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Farriols
authors.forename: Olivia
authors.initials: O
authors.lastname: Ferrández
authors.forename: José
authors.initials: J
authors.lastname: Planas
authors.forename: Pere
authors.initials: P
authors.lastname: Ortiz
authors.forename: Sergi
authors.initials: S
authors.lastname: Mojal
authors.forename: Ada I
authors.initials: AI
authors.lastname: Ruiz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use*; D011307:Drug Prescriptions; D004363:Drug Utilization / Q000639:trends*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D010166:Palliative Care / Q000639:trends*; D010818:Practice Patterns, Physicians' / Q000639:trends
chemical_list: D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D001569:Benzodiazepines