Adherence to antidepressant medications is associated with reduced premature mortality in patients with cancer: A nationwide cohort study

Abstract

Background: Depression and anxiety are common in cancer and antidepressants (AD) are efficacious treatment. The relationship between AD adherence and mortality in cancer is unclear. This study aimed to evaluate the association between adherence to AD and all‐cause mortality in a population‐based cohort of patients with cancer. Materials and Methods: We conducted a 4‐year historical prospective cohort study including 42,075 patients with cancer who purchased AD at least once during the study period. Adherence to AD was modeled as nonadherence (<20%), poor (20–50%), moderate (50–80%), and good (>80%) adherence. We conducted multivariable survival analyses adjusted for demographic and clinical variables that may affect mortality. Results: During 1,051,489 person‐years at risk follow‐up, the adjusted hazard ratios (HR) for mortality were 0.89 (95% confidence interval [CI]: 0.83–0.95), 0.77 (95% CI: 0.66–0.72), and 0.80 (95% CI: 0.76–0.85) for the poor, moderate, and good adherence groups, respectively, compared to the nonadherent group. Analysis of the entire sample and a subgroup with depression, for cancer subtypes, revealed similar patterns for breast, colon, lung, and prostate cancers, but not for melanoma patients. Multivariate predictors of premature mortality included male gender (HR 1.48 [95% CI: 1.42–1.55]), current/past smoking status (HR 1.1, [95% CI: 1.04–1.15]; P < .0001), low socioeconomic status (HR 1.1, [95% CI: 1.03–1.17]; P < .0001) and more physical comorbidities. Conclusions: The present study is the first to demonstrate that higher adherence to AD is associated with a decrease of all‐cause mortality in a large nationwide cohort of cancer patients. Our data add to the pressing need to encourage adherence to AD among cancer patients.

Targeting monoamine oxidase A-regulated tumor-associated macrophage polarization for cancer immunotherapy

“…Interest in MAOIs as a major class of antidepressants is reviving, and repurposing MAOIs for cancer immunotherapy can be an attractive application of these potent drugs 42 . Moreover, many cancer patients suffer from depression and anxiety; these overwhelming emotional changes can negatively interfere with the quality of life and cancer treatment efficacy of cancer patients 64 . Repurposing MAOIs for cancer immunotherapy thus may provide cancer patients with anti-depression and antitumor dual benefits, making this therapeutic strategy particularly attractive.…”

Targeting monoamine oxidase A-regulated TAM polarization for cancer immunotherapy

“…Therefore, interest in MAOIs as a major class of antidepressants is reviving, and repurposing MAOIs for cancer immunotherapy can be an attractive new application of these potent drugs 72 . Moreover, many cancer patients suffer from depression and anxiety; these overwhelming emotional changes can negatively interfere with the quality of life and cancer treatment e cacy of cancer patients 96 . Repurposing MAOIs for cancer immunotherapy thus may provide cancer patients with anti-depression and antitumour dual bene ts, making this therapeutic strategy particularly attractive.…”

Daganatos megbetegedések és a depresszió: rövid irodalmi áttekintés

“…5) Egyes vizsgálatok szerint a depressziós betegek kevésbé fogadják el a daganatellenes kezelés bizonyos formáit, illetve alapvetően rosszabb a kezeléshez való adherenciájuk, ami szintén oka lehet a rosszabb túlélésüknek [17,44,52,53].…”