Use of antidepressants and NSAIDs in relation to mortality in long-term breast cancer survivors

Pharmacoepidemiol Drug Saf. 2011 Feb;20(2):131-7. doi: 10.1002/pds.2064. Epub 2010 Nov 8.

Abstract

Purpose: The aim of this study was to assess the post-diagnosis use of antidepressants and non-steroidal anti-inflammatory drugs (NSAIDs) in relation to all-cause, breast cancer, and cardiovascular disease (CVD) mortality among long-term breast cancer survivors.

Methods: A cohort of 3058 breast cancer survivors, who previously participated in a series of case-control studies diagnosed between 1988 and 1999 in Wisconsin. Cancer survivors completed a self-administered mailed follow-up questionnaire in 1998-2001 that addressed use of medications post-diagnosis, including antidepressants and NSAIDs. Vital status information was obtained through the National Death Index through 31 December 2006. We used multivariable Cox proportional hazards modeling to estimate hazard ratios and 95% confidence intervals (CI).

Results: We identified 463 deaths due to all-causes, 163 due to breast cancer, and 93 due to CVD during follow-up. Among women who had used any antidepressant after a breast cancer diagnosis, there was an increased risk of all-cause (adjusted HR=1.50, 95%CI: 1.12-2.02) and CVD mortality (HR=2.42, 95%CI: 1.21-4.83), but not breast cancer mortality (HR=0.93, 95%CI: 0.55-1.56). The use of NSAIDs after diagnosis was not associated with all-cause (HR=0.87, 95%CI: 0.69-1.18), breast cancer mortality (HR=0.69, 95%CI: 0.44-1.10), or CVD (HR=0.97, 95%CI: 0.57-1.65).

Conclusions: The use of antidepressants or NSAIDS was not related to breast cancer mortality in long-term breast cancer survivors. In these women, however, antidepressants may increase the risk of all-cause mortality.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Antidepressive Agents / adverse effects*
  • Breast Neoplasms / mortality*
  • Breast Neoplasms / psychology
  • Breast Neoplasms / therapy
  • Cardiovascular Diseases / mortality*
  • Cause of Death
  • Female
  • Humans
  • Middle Aged
  • Proportional Hazards Models
  • Risk Assessment
  • Risk Factors
  • Surveys and Questionnaires
  • Survivors / statistics & numerical data*
  • Time Factors
  • Treatment Outcome
  • Wisconsin / epidemiology

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Antidepressive Agents