Antidepressivos tricíclicos associados com risco aumentado de câncer de próstata

Tamim H M; Mahmud S; Hanley J A; Boivin J-F and Stang M R. Antidepressants and Risk of Prostate Cancer: A Nested Case-Control Study. At Medscape Internal Medicine – Posted in 13/05/2008.

A associação entre medicamentos antidepressivos e risco de câncer tem recebido considerável atenção nos últimos anos. Esse estudo populacional, prospectivo, controlado, reunindo uma amostra expressiva de casos de câncer de próstata e controles, avaliados quanto ao uso de antidepressivos por até 24 anos, mostrou os seguintes dados. Os antidepressivos do grupo dos tricíclicos mostraram uma associação positiva para o risco de câncer de próstata, quando a exposição ocorreu de 2 a 5 anos antes do diagnóstico do câncer, com razão de taxas de 1,31, 1,58 e 2,42 para baixo, médio e alto consumo médio diário dos medicamentos, respectivamente. Já os antidepressivos do grupo dos Inibidores seletivos da Recaptação da Serotonina não mostraram uma associação significativa para o risco de câncer de próstata. Os autores ressaltam que a associação, apesar de ser dose dependente, é pequena e podem estar envolvidos outros vieses determinando essa associação.

Although the association between antidepressant drug use and risk of cancer has received considerable attention in the past years, no work has been done specifically on prostate cancer. We carried out a population-based case - control study to assess the risk of prostate cancer in association with exposure to tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs). 7767 prostate cancer cases diagnosed between 1981 and 2000 were accrued through the Saskatchewan Cancer Agency. Saskatchewan Health identified a total of 31 068 male controls who were matched on age and calendar time. Data on exposure to TCAs and SSRIs were compiled from the Saskatchewan outpatient prescription drug database, and covered a period upto 24 years. A positive significant association was found between TCA use and risk of prostate cancer, when exposure took place 2-5 years before diagnosis, with rate ratios of 1.31, 1.58, and 2.42 at the low, medium and high average daily dose levels, respectively. Exposure to SSRIs was not found to be significantly associated with the risk of prostate cancer. TCA use 2-5 years in the past was associated with a small dose-dependent increase in the risk of prostate cancer. Nevertheless, detection bias could have contributed to the observed association.

---