“Reviewing the evidence is a critical public health issue in light of the increasing prevalence of antidepressant use, especially among women, and in light of the fact that one in eight women will be diagnosed with cancer of the breast during their lifetime,’’ the investigators said in the report.
Lisa Cosgrove, a research lab fellow at Harvard’s Edmond J. Safra Center for Ethics and an associate professor of psychology at the University of Massachusetts Boston, led the review. The findings point to a need for more study of the use of selective serotonin reuptake inhibitors in women and the link to cancer, she said.
“I would want to consider nondrug treatment if I was mildly depressed, given our data,’’ Cosgrove said.
Antidepressants, used by 27 million Americans, are the third most prescribed class of drug in the United States, behind cholesterol-lowering medications and painkillers. Selective serotonin reuptake inhibitors, which raise levels of the chemical serotonin in the brain, have been shown to increase suicidal thoughts and behavior in teenagers and children, and the Food and Drug Administration in 2004 ordered that the medications carry the strictest warning on their labels.
The first such drug was Eli Lilly’s Prozac, approved by the FDA in 1987. A message left for Mark Taylor, a Lilly spokesman, was not immediately returned. Sarah Alspach, a spokeswoman for GlaxoSmithKline, the London-based maker of Paxil, declined to comment because no one at the company had had the opportunity to review the study.
Cosgrove and her five collaborators analyzed 26 epidemiological and 35 preclinical studies conducted between 1965 and 2010 that tested for a link between antidepressants and breast or ovarian cancer.
The increase in the risk of cancer was based on a meta-analysis of the 26 epidemiological studies. The Harvard project reanalyzed the studies to see whether the combined data would give a clearer picture of the risk.
The individual studies had mixed results. One published in 2000 by Dr. Michelle Cotterchio of the University of Toronto showed that compared with no antidepressant use, the breast-cancer risk for women who took tricyclic drugs (an older class of treatments) for more than two years doubled. Women taking paroxetine (branded as Paxil) faced a sevenfold increase, according to the same report.
