Hepatocellular carcinoma and antidepressants: a nationwide population-based study

Oncotarget. 2017 May 2;8(18):30464-30470. doi: 10.18632/oncotarget.12826.


Hepatocellular carcinoma (HCC) is highly prevalent in Asia. Antidepressants have been associated with increase in hepatocellular carcinoma. This is the first Asian population-based study to evaluate the association between antidepressant use and risk of HCC. Based on Taiwan's National Health Insurance Research Database, we conducted a nationwide population-based study. A total of 49,998 cases with HCC were identified and paired with 244,236 randomly selected controls. The data was analyzed via the conditional logistic regression model adjusting for several confounding factors. Use of tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) was associated with lower risk for HCC. No apparent association was found between use of other classes of antidepressants and HCC, including monoamine oxidase inhibitors (MAOIs), serotonin norepinephrine reuptake inhibitors (SNRIs), trazodone, mirtazapine and bupropion. The findings of a protective effect of TCAs and SSRIs for HCC should be interpreted with caution and warrants further research.

Keywords: Taiwan national insurance; antidepressants; hepatocellular carcinoma.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antidepressive Agents / adverse effects*
  • Carcinoma, Hepatocellular / epidemiology*
  • Carcinoma, Hepatocellular / etiology*
  • Case-Control Studies
  • Humans
  • Liver Neoplasms / epidemiology*
  • Liver Neoplasms / etiology*
  • Middle Aged
  • Odds Ratio
  • Population Surveillance
  • Socioeconomic Factors
  • Taiwan / epidemiology
  • Young Adult


  • Antidepressive Agents