Antidepressant use after diagnosis may reduce liver cancer mortality
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Key takeaways:
- Antidepressant use after liver cancer diagnosis linked to lower risk for overall and cancer-specific mortality.
- No association found between prediagnosis antidepressant use and mortality.
Postdiagnosis antidepressant use reduced mortality risk among patients with hepatocellular carcinoma, according to data published in JAMA Network Open.
The inverse relationship between postdiagnosis antidepressant use and decreased mortality risk remained consistent across antidepressant classes, researchers noted.
“Notably, we observed a consistent inverse association between postdiagnosis antidepressant use and mortality risk across various comorbidity subgroups, encompassing [hepatitis B virus] infection, [hepatitis C virus] infection, liver cirrhosis and alcohol use disorder,” Kuan-Lun Huang, MD, of Tsaotun Psychiatric Center in Nantou, Taiwan, and colleagues, wrote. “In contrast, no association was observed between the use of antidepressants before HCC diagnosis and reduced cancer-specific mortality or all-cause mortality.”
Background and methodology
Liver cancer currently serves as the third leading cause of cancer deaths worldwide, according to background data provided by the investigators.
Huang and colleagues sought to investigate the potential association between antidepressant use and mortality risk in patients with hepatocellular carcinoma, in what they believed to be the first such national cohort study of its kind.
The population-based cohort study analyzed information from Taiwan’s National Health Insurance Research Database. The analysis included 308,938 adults (65.6% male; 42.7% aged 65 years or older) with a new diagnosis of hepatocellular carcinoma between 1999 and 2017, with follow-up continuing until 2018 to measure overall and cancer-specific mortality.
Analysis of compiled data took place in June 2023.
Results, next steps
Researchers observed no association between antidepressant use prior to hepatocellular carcinoma diagnosis and overall mortality (adjusted HR = 1.1; 95% CI, 1.08-1.12) or cancer-specific mortality (adjusted HR = 1.06; 95% CI, 0.96-1.17).
However, researchers did note an association between antidepressant use following the diagnosis of hepatocellular carcinoma and lower risk for overall mortality (adjusted HR = 0.69; 95% CI, 0.68-0.7) and cancer-specific mortality (adjusted HR = 0.63; 95% CI, 0.59-0.68).
Observed associations remained consistent across subgroups with different antidepressant classes and comorbidities, researchers noted, including hepatitis B virus or hepatitis C virus infection, liver cirrhosis and alcohol use disorders.
Researchers noted several study limitations, including being limited to Taiwanese population data, information on some potential confounders not being available in the National Health Insurance Research Database and the potential for misclassification bias due to some study participants not adhering to antidepressant medication.
Further research through randomized clinical trials is needed to provide definitive evidence of decreased mortality risk, according to researchers.
“Our study provides promising empirical results indicating that antidepressants may have utility as anticancer therapeutics in patients with [hepatocellular carcinoma],” Huang and colleagues wrote. “However, our findings should be interpreted cautiously because the associations found in this observational study may not indicate causality and may be affected by residual confounding or biases.”
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