Use of Antidepressant Medications and the Possible Association with Breast Cancer Risk

Bahl, Saira; Cotterchio, Michelle; Kreiger, Nancy

doi:10.1159/000070782

Cited by 38 publications

(22 citation statements)

References 43 publications

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“…Similarly, psychological distress may differ between patients with advanced and those with early-stage disease. Furthermore, the association between the use of antidepressants and subsequent breast cancer risk has been widely debated in the literature [39]. Therefore it is important to measure the degree of the association between cancer and mental disorders by considering cancer site and stage.…”

Section: Discussionmentioning

confidence: 99%

Cancer and Mental Disorders in a National Community Sample: Findings from the National Comorbidity Survey

Honda

Goodwin

2004

Psychother Psychosom

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Objective: To determine the association between cancer (past 12 months) and mental disorders (past 12 months) among community-dwelling adults. Methods: Data were drawn from the National Comorbidity Survey (n = 5,877), a representative household sample of adults aged 15–54 years in the United States. Multiple logistic regression analyses were used to determine the association between cancer and mental disorders, adjusting for differences in sociodemographic characteristics. Results: Cancer was significantly associated with increased rates of major depression [odds ratio (OR) = 3.6, 95% confidence interval (CI) = 1.4–8.8], drug dependence (OR = 3.6, 95% CI = 1.3–9.8), simple phobia (OR = 2.5, 95% CI = 1.0–6.2) and agoraphobia (OR = 3.3, 95% CI = 1.0–10.4). These associations persisted after adjusting for major sociodemographic factors, and sex plays a significant role in the association between cancer diagnosis and mental disorder, with cancer diagnosis having a stronger influence on major depression and drug dependence in men than in women. Conclusions: Clinicians and community health workers working with cancer survivors need to be not only alert for signs of clinical depression but also of co-occurring drug dependence and certain anxiety disorders so that appropriate referrals to mental health professionals can be made.

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Section: Discussionmentioning

confidence: 99%

Cancer and Mental Disorders in a National Community Sample: Findings from the National Comorbidity Survey

Honda

Goodwin

2004

Psychother Psychosom

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“…However, PCPs may encounter in their clinical practice many different circumstances prompting the prescription of antidepressant drugs, like distressing mixed anxiety and depressive symptoms or a prior history of major depression. The risk-benefit ratio is hard to evaluate in these cases, considering also that in addition to well-known side effects, antidepressants may be related to an increased risk of suicide and breast cancer, as suggested by recent research [27, 28]. Moreover, some authors have gone so far as to suggest that prolonged treatment, especially when unnecessary, may worsen the biological pathways and, accordingly, the course of depression as well [29, 30].…”

Section: Discussionmentioning

confidence: 99%

Increased Recognition of Depression in Primary Care

Berardi

Menchetti

Cevenini

et al. 2005

Psychother Psychosom

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Background: Underrecognition and undertreatment of depression in primary care has been regarded as a major public health problem. In contrast, some studies found that among patients labeled as depressed by primary-care physicians (PCPs), a relevant proportion do not satisfy international diagnostic criteria for depression. The aims of this study are: (1) to assess disparity between PCP diagnosis and research diagnosis of depression; (2) to compare antidepressant treatment in concordant and discordant cases of depression. Methods: Data are gathered from a national survey on depressive disorders in primary care, conducted with the collaboration of 191 PCPs. Three hundred and sixty-one PCP patients were evaluated, and their psychiatric diagnosis was established by the ‘unaided’ PCPs and by using a research interview for depression. Results: PCPs recognized 79.4% of cases of depression and prescribed antidepressants to 40.9% of them. Yet, 45.0% of patients labeled as depressed by the PCPs were not cases of depression according to ICD-10 criteria; 26.9% of false-positive cases received an antidepressant. Globally, 35% of antidepressants for ‘depression’ were prescribed to false-positive cases. Conclusions: Underrecognition and undertreatment of depression in primary care seem to be less alarming. Conversely, PCP diagnoses of depression appear to be more inclusive than psychiatric diagnostic criteria. A possible consequence of this apparently more inclusive diagnostic threshold may be an excessive use of antidepressants. These changes require a corresponding change in research, toward efficacy and safety of the treatment of milder cases, and in education, toward the distinction between the management of mild and severe cases of depression.

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“…Studies do not support a specific link between antidepressant medications and increased breast cancer risk regardless of duration of use, daily dose, specific drug used (SSRIs, TCAs) [77][78][79][80][81][82].…”

Section: Antidepressant Medications and Breast Cancer Riskmentioning

confidence: 99%

“…The possibility of an association has not been excluded, although further studies are needed before the body of scientific evidence can be definitively conclusive [82].…”

Section: Antidepressant Medications and Breast Cancer Riskmentioning

confidence: 99%

Depression, quality of life and breast cancer: a review of the literature

Reich

Lesur

Perdrizet-Chevallier³

2007

Breast Cancer Res Treat

395

200

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Depression is misdiagnosed and undertreated among breast cancer population. Risk factors for depression in the 5 years after diagnosis are related more to the patient rather than to the disease or its treatment. The breast cancer stage (early and advanced) is not statistically significant in terms of rates of psychosocial distress except for recurrence. Risk factors of depression might impair quality of life such as fatigue, past history or recent episode of depression after the onset of cancer, cognitive attitudes of helplessness/hopelessness, resignation. Body image impairment from mastectomy and sexuality aftermath generates higher rates of mood disorders. The link between increased risk of breast cancer and depression is controversial among the literature. Some studies suggest a protective factor, others find a relation between stress, immunity and cancer occurrence or even mortality. Breast cancer survivors report a higher prevalence of mild to moderate depression with a lower quality of life in all areas except for family functioning. Treatment of depression in breast cancer women improves their quality of life and may increase longevity. Antidepressant medications remain the cornerstone of depression treatment. The hypothetical link between their prescription and increased breast cancer risk is not supported by literature's data.

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Use of Antidepressant Medications and the Possible Association with Breast Cancer Risk

Cited by 38 publications

References 43 publications

Cancer and Mental Disorders in a National Community Sample: Findings from the National Comorbidity Survey

Cancer and Mental Disorders in a National Community Sample: Findings from the National Comorbidity Survey

Increased Recognition of Depression in Primary Care

Depression, quality of life and breast cancer: a review of the literature

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