Whether treating prostate cancer survivors with a depressive disorder with antidepressants can affect their cancer outcomes is unknown. We evaluated the association between antidepressant use and prostate cancer recurrence, in survivors with comorbid depressive disorders.
We conducted a longitudinal cohort study of 10,017 men with prostate cancer (stages I-II) diagnosed who also had a comorbid depressive disorder followed a maximum of 22 years, and examined rates of biochemical recurrence by antidepressant medication use. We conducted multivariable Cox models based on time-dependent antidepressant drug use status, and examined the risk of biochemical recurrence by cumulative duration of antidepressant use.
Of these 10,017 survivors, 1842 (18%) experienced biochemical recurrence over 69,500 person-years of follow-up. The prostate cancer biochemical recurrence rate was greater with antidepressant non-use (31.3/1000 person-years) compared to antidepressant use (23.5/1000 person-years). In Cox proportional hazards multivariable adjusted models, non-use of antidepressants was associated with a 34% increased risk of biochemical recurrence compared to antidepressant use (HR = 1.34, 95% CI: 1.24-1.44). Longer use of antidepressants was associated with a lower biochemical recurrence risk (P trend test < 0.001).
Untreated depressive disorders in prostate cancer patients may be associated with an increased risk of biochemical recurrence.
Cancer causes & control : CCC. 2022 Sep 09 [Epub ahead of print]
Reina Haque, Stephanie Reading, Michael R Irwin, Lie Hong Chen, Jeff Slezak
Department of Research & Evaluation, Kaiser Permanente Southern California, 100 South Los Robles, 2nd Floor, Pasadena, CA, 91101, USA. ., Department of Research & Evaluation, Kaiser Permanente Southern California, 100 South Los Robles, 2nd Floor, Pasadena, CA, 91101, USA., Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, 90095, USA.