Pharmacopsychiatry
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 (eFirst)

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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.