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Pharmacopsychiatry 2019; 52(03): 134-141
DOI: 10.1055/a-0596-0819
Original Paper
© Georg Thieme Verlag KG Stuttgart · New York

Antidepressant Prescription and Risk of Lung Cancer: A Nationwide Case-Control Study

Chia-Jui Tsai
1   Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan
2   Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
,
Wei-Che Chiu   *
3   Department of Psychiatry, Cathay General Hospital, Taipei, Taiwan
4   School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan
,
Chia-Ju Chen
5   Department of Psychiatry, Minder Hospital, Changhua, Taiwan
,
Pau-Chung Chen
6   Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan
7   Department of Environmental and Occupational Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
,
Roger S. McIntyre
8   Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
9   Department of Psychiatry, University of Toronto, Toronto, ON, Canada
10   Department of Pharmacology, University of Toronto, Toronto, ON, Canada
,
Vincent Chin-Hung Chen   *
11   Chang Gung University, Taoyuan, Taiwan
12   Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi, Taiwan
13   Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi, Taiwan
› Author Affiliations
Further Information

Publication History

received 09 August 2017
revised 17 January 2018

accepted 12 March 2018

Publication Date:
16 April 2018 (online)

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Abstract

Introduction In recent decades, concern about safety of antidepressants has been raised but the risk between antidepressants and lung cancer has not yet been established.

Methods A case-control study was conducted by using a nationwide database in Taiwan. The case groups were new onset lung cancer diagnosis during 1999–2008 and age- and gender-matched controls were selected among those without any cancer. The cumulative exposure dose before the lung cancer diagnosis was added and risks were calculated according to the levels of defined daily dose and classes of antidepressants.

Results A total of 39,001 individuals with lung cancer and 189,906 individuals without lung cancer between 1999 and 2008 were included in the analysis. Antidepressants, of any class, were not associated with elevated risks for lung cancer with the exception of bupropion at high exposure levels (odds ratio=4.81, 95% confidence interval=1.39–16.71).

Discussion Antidepressant prescription was not associated with elevation of lung cancer incidence using a nationally representative sample. The elevated risk for lung cancer with bupropion at high doses may be a bias by indication and warrant longitudinal investigation.

Key words

antidepressants - lung cancer - national health insurance database - catastrophic illness - defined daily dose

* These authors contributed equally to this work.


 

  • References

  • 1 Bae KY, Kim SW, Kim JM. et al. Antidepressant prescribing patterns in Korea: Results from the clinical research center for depression study. Psychiatry Investig 2011; 8: 234-244
    CrossrefPubMedGoogle Scholar
  • 2 Lockhart P, Guthrie B. Trends in primary care antidepressant prescribing 1995–2007: A longitudinal population database analysis. Br J Gen Pract 2011; 61: e565-e572
    CrossrefPubMedGoogle Scholar
  • 3 Nakagawa A, Grunebaum MF, Ellis SP. et al. Association of suicide and antidepressant prescription rates in Japan, 1999–2003. J Clin Psychiatry 2007; 68: 908-916
    CrossrefPubMedGoogle Scholar
  • 4 Pirraglia PA, Stafford RS, Singer DE. Trends in prescribing of selective serotonin reuptake inhibitors and other newer antidepressant agents in adult primary care. Prim Care Companion J Clin Psychiatry 2003; 5: 153-157
    CrossrefPubMedGoogle Scholar
  • 5 Sternbach H. Are antidepressants carcinogenic? A review of preclinical and clinical studies. J Clin Psychiatry 2003; 64: 1153-1162
    CrossrefPubMedGoogle Scholar
  • 6 Tutton PJ, Barkla DH. Influence of inhibitors of serotonin uptake on intestinal epithelium and colorectal carcinomas. Br J Cancer 1982; 46: 260-265
    CrossrefPubMedGoogle Scholar
  • 7 Brandes LJ, Arron RJ, Bogdanovic RP. et al. Stimulation of malignant growth in rodents by antidepressant drugs at clinically relevant doses. Cancer Res 1992; 52: 3796-3800
    PubMedGoogle Scholar
  • 8 Iishi H, Tatsuta M, Baba M. et al. Enhancement by the tricyclic antidepressant, desipramine, of experimental carcinogenesis in rat colon induced by azoxymethane. Carcinogenesis 1993; 14: 1837-1840
    CrossrefPubMedGoogle Scholar
  • 9 Eisen JN, Irwin J, Quay J. et al. The effect of antidepressants on immune function in mice. Biol Psychiatry 1989; 26: 805-817
    CrossrefPubMedGoogle Scholar
  • 10 Wright SC, Zhong J, Larrick JW. Inhibition of apoptosis as a mechanism of tumor promotion. FASEB J 1994; 8: 654-660
    CrossrefPubMedGoogle Scholar
  • 11 Volpe DA, Ellison CD, Parchment RE. et al Effects of amitriptyline and fluoxetine upon the in vitro proliferation of tumor cell lines. J Exp Ther Oncol 2003; 3: 169-184
    CrossrefPubMedGoogle Scholar
  • 12 Serafeim A, Holder MJ, Grafton G. et al. Selective serotonin reuptake inhibitors directly signal for apoptosis in biopsy-like Burkitt lymphoma cells. Blood 2003; 101: 3212-3219
    CrossrefPubMedGoogle Scholar
  • 13 Abdul M, Logothetis CJ, Hoosein NM. Growth-inhibitory effects of serotonin uptake inhibitors on human prostate carcinoma cell lines. J Urol 1995; 154: 247-250
    CrossrefPubMedGoogle Scholar
  • 14 Haukka J, Sankila R, Klaukka T. et al. Incidence of cancer and antidepressant medication: Record linkage study. Int J Cancer 2010; 126: 285-296
    CrossrefPubMedGoogle Scholar
  • 15 Eom CS, Park SM, Cho KH. Use of antidepressants and the risk of breast cancer: A meta-analysis. Breast Cancer Res Treat 2012; 136: 635-645
    CrossrefPubMedGoogle Scholar
  • 16 Xu W, Tamim H, Shapiro S. et al. Use of antidepressants and risk of colorectal cancer: A nested case-control study. Lancet Oncol 2006; 7: 301-308
    CrossrefPubMedGoogle Scholar
  • 17 Chubak J, Boudreau DM, Rulyak SJ. et al. Colorectal cancer risk in relation to antidepressant medication use. Int J Cancer 2011; 128: 227-232
    CrossrefPubMedGoogle Scholar
  • 18 Nordenberg J, Fenig E, Landau M. et al. Effects of psychotropic drugs on cell proliferation and differentiation. Biochem Pharmacol 1999; 58: 1229-1236
    CrossrefPubMedGoogle Scholar
  • 19 Siegel R, Ma J, Zou Z. et al. Cancer statistics, 2014. CA Cancer J Clin 2014; 64: 9-29
    CrossrefPubMedGoogle Scholar
  • 20 Jahchan NS, Dudley JT, Mazur PK. et al. A drug repositioning approach identifies tricyclic antidepressants as inhibitors of small cell lung cancer and other neuroendocrine tumors. Cancer Discov 2013; 3: 1364-1377
    CrossrefPubMedGoogle Scholar
  • 21 Ortiz T, Villanueva-Paz M, Diaz-Parrado E. et al. Amitriptyline down-regulates coenzyme Q10 biosynthesis in lung cancer cells. Eur J Pharmacol 2017; 797: 75-82
    CrossrefPubMedGoogle Scholar
  • 22 Toh S, Rodriguez LA, Hernandez-Diaz S. Use of antidepressants and risk of lung cancer. Cancer Causes Control 2007; 18: 1055-1064
    CrossrefPubMedGoogle Scholar
  • 23 Boursi B, Lurie I, Mamtani R. et al. Anti-depressant therapy and cancer risk: a nested case-control study. Eur Neuropsychopharmacol 2015; 25: 1147-1157
    CrossrefPubMedGoogle Scholar
  • 24 Lohinai Z, Dome P, Szilagyi Z. et al. From bench to bedside: Attempt to evaluate repositioning of drugs in the treatment of metastatic small cell lung cancer (SCLC). PloS One 2016; 11: e0144797
    CrossrefPubMedGoogle Scholar
  • 25 Zhou W, Christiani DC. East meets West: Ethnic differences in epidemiology and clinical behaviors of lung cancer between East Asians and Caucasians. Chin J Cancer 2011; 30: 287-292
    CrossrefPubMedGoogle Scholar
  • 26 Hsieh YH, Chiu WC, Lin CF. et al. Antidepressants and gastric cancer: a nationwide population-based nested case-control study. PloS One 2015; 10: e0143668
    CrossrefPubMedGoogle Scholar
  • 27 Wacholder S, Silverman DT, McLaughlin JK. et al. Selection of controls in case-control studies. III. Design options. Am J Epidemiol 1992; 135: 1042-1050
    CrossrefPubMedGoogle Scholar
  • 28 Natsch S, Hekster YA, de Jong R. et al Application of the ATC/DDD methodology to monitor antibiotic drug use. Eur J Clin Microbiol Infect Dis 1998; 17: 20-24
    CrossrefPubMedGoogle Scholar
  • 29 Brasky TM, Baik CS, Slatore CG. et al. Non-steroidal anti-inflammatory drugs and small cell lung cancer risk in the VITAL study. Lung Cancer 2012; 77: 260-264
    CrossrefPubMedGoogle Scholar
  • 30 Slatore CG, Au DH, Littman AJ. et al. Association of nonsteroidal anti-inflammatory drugs with lung cancer: results from a large cohort study. Cancer Epidemiol Biomarkers Prev 2009; 18: 1203-1207
    CrossrefPubMedGoogle Scholar
  • 31 Hung MS, Chen IC, Lee CP. et al. Statin improves survival in patients with EGFR-TKI lung cancer: A nationwide population-based study. PloS One 2017; 12: e0171137
    CrossrefPubMedGoogle Scholar
  • 32 Huang WY, Li CH, Lin CL. et al. Long-term statin use in patients with lung cancer and dyslipidemia reduces the risk of death. Oncotarget 2016; 7: 42208-42215
    PubMedGoogle Scholar
  • 33 Cardwell CR, McMenamin U, Hughes CM. et al. Statin use and survival from lung cancer: a population-based cohort study. Cancer Epidemiol Biomarkers Prev 2015; 24: 833-841
    CrossrefPubMedGoogle Scholar
  • 34 Xu Z, Yu D, Yin X. et al. Socioeconomic status is associated with global diabetes prevalence. Oncotarget 2017; 8: 44434-44439
    CrossrefPubMedGoogle Scholar
  • 35 Kuwahara J, Yamada T, Egashira N. et al. Comparison of the anti-tumor effects of selective serotonin reuptake inhibitors as well as serotonin and norepinephrine reuptake inhibitors in human hepatocellular carcinoma cells. Biol Pharm Bull 2015; 38: 1410-1414
    CrossrefPubMedGoogle Scholar
  • 36 Jang EH, Park CS, Kang JH. Bupropion, an atypical antidepressant, induces endoplasmic reticulum stress and caspase-dependent cytotoxicity in SH-SY5Y cells. Toxicology 2011; 285: 1-7
    CrossrefPubMedGoogle Scholar
  • 37 Leone FT, Evers-Casey S, Toll BA. et al. Treatment of tobacco use in lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2013; 143: e61S-e77S
    CrossrefPubMedGoogle Scholar
  • 38 Schachter EN, Neuman T. Targeted therapies for the prevention of lung cancer. Drugs Today (Barc) 2007; 43: 897-936
    CrossrefPubMedGoogle Scholar
  • 39 Kessler RC, Berglund P, Demler O. et al. The epidemiology of major depressive disorder: Results from the National Comorbidity Survey Replication (NCS-R). JAMA 2003; 289: 3095-3105
    CrossrefPubMedGoogle Scholar
  • 40 Weissman MM, Bland RC, Canino GJ. et al. Cross-national epidemiology of major depression and bipolar disorder. JAMA 1996; 276: 293-299
    CrossrefPubMedGoogle Scholar
  • 41 Chiu E. Epidemiology of depression in the Asia Pacific region. Australas Psychiatry 2004; 12 Suppl S4-S10
    CrossrefPubMedGoogle Scholar
  • 42 Baxter AJ, Scott KM, Ferrari AJ. et al. Challenging the myth of an “epidemic” of common mental disorders: trends in the global prevalence of anxiety and depression between 1990 and 2010. Depress Anxiety 2014; 31: 506-516
    CrossrefPubMedGoogle Scholar
  • 43 Chien IC, Kuo CC, Bih SH. et al. The prevalence and incidence of treated major depressive disorder among National Health Insurance enrollees in Taiwan, 1996 to 2003. Can J Psychiatry 2007; 52: 28-36
    CrossrefPubMedGoogle Scholar
  • 44 Lin TY. Culture and psychiatry: A Chinese perspective. Aust N Z J Psychiatry 1982; 16: 235-245
    CrossrefPubMedGoogle Scholar
  • 45 Compton 3rd WM, Helzer JE, Hwu HG. et al. New methods in cross-cultural psychiatry: Psychiatric illness in Taiwan and the United States. Am J Psychiatry 1991; 148: 1697-1704
    CrossrefPubMedGoogle Scholar
  • 46 Park B, Youn S, Yi KK. et al. The prevalence of depression among patients with the top ten most common cancers in South Korea. Psychiatry Investig 2017; 14: 618-625
    CrossrefPubMedGoogle Scholar
  • 47 Chambers SK, Baade P, Youl P. et al. Psychological distress and quality of life in lung cancer: The role of health-related stigma, illness appraisals and social constraints. Psychooncology 2015; 24: 1569-1577
    CrossrefPubMedGoogle Scholar
  • 48 Chapple A, Ziebland S, McPherson A. Stigma, shame, and blame experienced by patients with lung cancer: Qualitative study. BMJ 2004; 328: 1470
    CrossrefPubMedGoogle Scholar
  • 49 Tsai LT, Lo FE, Yang CC. et al. Influence of socioeconomic factors, gender and indigenous status on smoking in Taiwan. Int J Environ Res Public Health 2016; 13: E1044
    CrossrefPubMedGoogle Scholar
  • 50 Sacco JJ, Al-Akhrass H, Wilson CM. Challenges and strategies in precision medicine for non-small-cell lung cancer. Curr Pharm Des 2016; 22: 4374-4385
    CrossrefPubMedGoogle Scholar