Abstract
Background This study aimed to assess the association between the risk of
colorectal cancer (CRC) and exposure to mood stabilizers, antidepressants, and
antipsychotics in patients with affective disorders.
Methods This nested case-control study used data from the National Health
Insurance Database of Taiwan collected between 2001 and 2011. All participants
in this study had affective disorders. Then, 1209 patients with CRC and 1:10
matched controls were identified based on their demographic and clinical
characteristics. A logistic regression model adjusted for demographic and
clinical characteristics was used to determine the risk of developing CRC after
exposure to psychotropic drugs.
Results Among patients with affective disorders, exposure to mood
stabilizers (reported as odds ratio; 95% confidence interval; 0.75; 0.57–0.98),
antidepressants (0.83; 0.70–0.97), second-generation antipsychotics (0.67;
0.52–0.86), and first-generation antipsychotics (0.65; 0.52–0.81) were
associated with a reduced risk of CRC compared to patients who were not exposed.
When considering specific drugs, carbamazepine (0.34; 0.12–0.95), valproic acid
(0.66; 0.46–0.95), gabapentin (0.44; 0.20–0.99), fluoxetine (0.82; 0.68–0.99),
paroxetine (0.63; 0.45–0.87), and venlafaxine (0.72; 0.55–0.95) were associated
with a lower risk of CRC.
Conclusion Exposure to psychotropic drugs in patients with affective
disorders is associated with a lower risk of CRC compared to those who were not
exposed. Although the causal relationship between psychotropic drug exposure and
reduced risk of CRC could not be inferred directly, these findings may help
clinicians and patients in clinical decision-making.
Keywords
colorectal cancer - affective disorder - mood stabilizer - antidepressant - antipsychotic
