Antidepressant Use Affects Recurrence in PCa Survivors

According to a study published in Cancer Causes & Control, it is unknown if antidepressants impact outcomes in prostate cancer survivors. Thus, Reina Haque and colleagues sought to identify associations between antidepressant use and recurrence in prostate cancer survivors with comorbid depressive disorders. The researchers ultimately concluded that untreated depressive disorders could be associated with an increased risk of cancer recurrence in patients with prostate cancer.

This was a longitudinal cohort study including 10,017 men with prostate cancer of stages I to II who also had a comorbid depressive disorder diagnosis from a managed care system. Rates of biochemical recurrence and antidepressant use were assessed over a maximum follow-up of of 22 years. Researchers used time-dependant Cox models to estimate recurrence risk according to cumulative duration of medication use.

Untreated Depressive Disorders Associated With Prostate Cancer Recurrence

The investigators reported that 1,842 of 10,017 (18%) patients experienced biochemical recurrence over 69,500 person-years of follow-up. Notably, the rate of prostate cancer recurrence was higher in patients without antidepressant use (31.3/1000 person-years) compared to those with use (23.5/1000 person-years).

In addition, the Cox proportional hazard models revealed that prostate cancer survivors with a depressive disorder who did not use antidepressants had a 34% increased risk of biochemical recurrence compared to those with antidepressant use (hazard ratio [HR] 1.34; 95% CI, 1.24-1.44). Moreover, the authors noted that longer use of antidepressant medications was associated with a reduced risk of biochemical recurrent (P<.001).

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The researchers also discovered that only 60% this population of patients with prostate cancer and documented depressive symptoms received antidepressant therapy—consistent with a recent meta-analysis which found that only half of patients with cancer with depressive symptoms detected in screening received pharmacologic treatment.

The authors acknowledged that antidepressant medications are not appropriate for all patients, but noted they are used more often than psychological interventions in managed care systems due to inadequate resources.

“Our findings highlight that depression screening is needed as a part of cancer survivorship care plans given that early identification of depression and its treatment (via medications, psychotherapy, or other behavioral interventions) has the potential to improve both depression and cancer outcomes,” Haque closed.

View More Research at the DocWire News Prostate Cancer Resource Center