Chronic therapy with selective serotonin reuptake inhibitors and survival in newly diagnosed cancer patients

Depression might be associated with shorter disease specific survival. Selective serotonin reuptake inhibitors (SSRIs) were previously reported to increase the risk of certain malignancies. We aimed to evaluate the impact of SSRIs on cancer mortality. Five retrospective cohort studies were conducted in a UK population-representative database that included all individuals with an incident diagnosis of melanoma, breast, prostate lung and colorectal cancer. The primary exposure of interest was continuous use of SSRIs with past use as the comparison reference. Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CI). The study included 5,591 newly diagnosed cancer patients. Continuous SSRI use was associated with lower survival compared to past users for melanoma, breast, prostate, lung and colorectal cancers with HRs for the risk of death of 2.02 (95% CI 1.24-3.28), 1.91 (95% CI 1.53-2.38), 1.79 (95% CI 1.38-2.33), 1.44 (95% CI 1.19-1.75) and 1.51 (95% CI 1.21-1.72) respectively. The incidence of death during the first 2years following cancer diagnosis associated with continuous SSRI use were elevated for breast (1.72, 95% CI 1.30-2.27), prostate (1.64, 95% CI 1.20-2.24) and lung cancers (1.45, 95% CI 1.26-1.66). In conclusion, continuous use of SSRIs might be associated with lower survival in cancer patients.