Antidepressants and Survival in Glioma-A Registry-based Retrospective Cohort Study

Overview

Journal Neurooncol Pract

Publisher Oxford University Press

Date 2024 Mar 18

PMID 38496917

Authors

Sonja Edstrom

Barbro Numan Hellquist

Maria Sandstrom

Sajna Anand Sadanandan

Benny Bjorkblom

Beatrice Melin

Rickard L Sjoberg

Affiliations

Soon will be listed here.

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%), < .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, < .001), and non-SSRI treatment a HR of 3.54 (95% CI 2.52-4.99, < .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, < .001), and for non-SSRI treatment was 7.71 (95% CI 4.22-14.12, < .001).

Conclusions: Our results demonstrate a negative association between antidepressant medication and survival in glioma. Further research will be needed to clarify causation.

Citing Articles

Impact of antidepressant use on survival outcomes in glioma patients: A systematic review and meta-analysis.

Ge Y, Cao Y, Wang Q, Wang Y, Ma W Neurooncol Adv. 2024; 6(1):vdae181.

PMID: 39582812 PMC: 11582889. DOI: 10.1093/noajnl/vdae181.

Antidepressant drugs and risk of developing glioma: a national registry-based case-control study and a meta-analysis.

Malmberg C, Numan Hellquist B, Sadanandan S, Sandstrom M, Wu W, Bjorkblom B Am J Epidemiol. 2024; 193(11):1592-1599.

PMID: 38825331 PMC: 11538564. DOI: 10.1093/aje/kwae100.

Antidepressants and survival in glioma: Unraveling a complex puzzle.

Rooney A Neurooncol Pract. 2024; 11(2):111-112.

PMID: 38496915 PMC: 10940819. DOI: 10.1093/nop/npae010.

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