Affiliation:
1. Department of Clinical Sciences, Neurosciences, Umeå University , Umeå , Sweden
2. Department of Radiation Sciences, Oncology, Umeå University , Umeå , Sweden
3. Department of Chemistry, Umeå University , Umeå , Sweden
Abstract
Abstract
Background
Depression and treatment with antidepressant medication is common in patients with malignant glioma. However, the extent to which antidepressants may affect the disease is not fully understood. Therefore, the purpose of the present study was to investigate possible associations between treatment with antidepressant medication and survival in glioma patients.
Methods
We performed a registry-based cohort study including 1231 patients with malignant glioma (WHO grades 2, 3, and 4) having undergone surgery, and 6400 matched controls without glioma. All data were extracted from the RISK North database, which contains information from multiple national population-based registries in Sweden.
Results
Treatment with antidepressants is more common in patients with malignant glioma (27%), compared to controls (16%), P < .001. Treatment with antidepressants after surgery for glioma was significantly associated with poorer survival. These effects were observed both for selective serotonin reuptake inhibitors (SSRIs) and non-SSRIs. In grade 4 glioma, SSRI treatment was associated with a hazard ratio (HR) of 3.32 (95% CI 2.69–4.10, P < .001), and non-SSRI treatment a HR of 3.54 (95% CI 2.52–4.99, P < .001), compared to glioma patients without antidepressants. In grade 2-3 glioma, the HR for SSRI treatment was 3.26 (95% CI 2.19–4.85, P < .001), and for non-SSRI treatment was 7.71 (95% CI 4.22–14.12, P < .001).
Conclusions
Our results demonstrate a negative association between antidepressant medication and survival in glioma. Further research will be needed to clarify causation.
Funder
Regional Cancer Centre of Northern Sweden
Swedish Research Council
Swedish Cancer Foundation
County Council of Västerbotten
Publisher
Oxford University Press (OUP)