Assessing the impact of antidepressants on ovarian cancer risk
Past epidemiological investigations resulted in inconsistent reports on the affiliation between antidepressants and the risk of ovarian cancer.
Duration and intensity of antidepressant treatment does not have an impact on epithelial ovarian cancer risk, according to research published in the British Journal of Clinical Pharmacology.
Researchers conducted a meta-analysis of 8 studies published between 1984 and 2017 that examined the link between antidepressant use and epithelial ovarian cancer risk. Study data included 7878 cases of epithelial ovarian cancer and 73,913 controls.
High heterogeneity was noted among the studies (I2=74.4% P <.001). Researchers found that antidepressant use was not significantly linked to risk for endothelial ovarian cancer, compared with nonuse of antidepressants (odds ratio [OR]: 1.10; 95% CI, 0.91-1.32). When grouped based on type of antidepressant, similar results were noted: the use of selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, and other antidepressant drugs did not increase epithelial ovarian cancer risk (OR: 1.04, 1.01, and 0.91; 95% CI, 0.80-1.35, 0.79-1.30, and 0.74-1.12, respectively).
Data were also examined for links between duration and intensity of antidepressant use and risk for epithelial ovarian cancer risk. To determine the impact of duration, 6 studies were assessed (7165 cases and 71,644 controls); pooled ORs for these analyses were 0.89 (95% CI, 0.66-1.19; I2=35%; P =.174). The impact of intensity was assessed using 2 studies (4417 cases and 59,496 controls); pooled OR was 0.79 (95% CI, 0.62-1.02; I2=17.4%; P =.271).
Further subgroup analysis, stratified based on type of control subject, geographic location, exposure assessment, case number, and potential confounder adjustment, indicated that ORs were “broadly consistent.” After including studies with the largest heterogeneity (I2<50%), pooled ORs were similar to original outcomes (OR: 1.00; 95% CI, 0.86-1.16; I2=48.4%).
One limitation of this study was the researchers' inability to adjust for all potential confounders. They wrote, “nulliparity and infertility may not only be associated with [epithelial ovarian cancer], but also [with] antidepressant use. However, only 4 studies considered these factors… [F]uture studies should investigate this association after careful and thorough adjustment for potential confounders.”
Although this meta-analysis showed no association between antidepressant use or duration or intensity of treatment and epithelial ovarian cancer, the researchers concluded that further prospective studies “are warranted to confirm these findings.”
- Huo Y-L, Qiao J-M, Gao S. Association between antidepressant medication use and epithelial ovarian cancer risk: a systematic review and meta-analysis of observational studies [published online January 2, 2018]. Br J Clin Pharmacol. doi:10.1111/bcp.13498