Patients with cancer often experience depression and anxiety, and these comorbid conditions are independent risk factors for premature mortality. Many patients with cancer take antidepressants to manage these conditions, but little is known about the link between antidepressant use and mortality in patients with cancer. To evaluate this, a large, nationwide, 4-year historical cohort study evaluated long-term outcomes in 42,075 patients with cancer who purchased antidepressants at least once. Antidepressant adherence among patients was classified as nonadherent (< 20%), poor (20% to 50%), moderate (50% to 80%), and good (> 80%).
Antidepressant use was associated with decreased risk of mortality in patients with cancer. Compared to nonadherent patients, patients with moderate or good adherence had a one quarter reduction in mortality. The greatest benefit seen with antidepressant use was among those patients with moderate (50% to 80%) adherence (HR 0.77 compared to nonadherence), while patients with greater than 80% adherence did not experience an additional benefit (HR 0.80). Independent predictors of premature mortality included male sex, current or past smoking, low socioeconomic status, and a greater number of physical comorbidities.
The authors concluded that this study demonstrates that higher adherence to antidepressants during cancer treatment is associated with decreased rates of all-cause mortality. While this study provides evidence supporting the use of antidepressants in cancer patients, additional studies will be needed to understand the validity of the relationship between antidepressant use and cancer mortality.
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