Risk of epithelial ovarian cancer in relation to use of antidepressants, benzodiazepines, and other medications acting on the central nervous system

Abstract

An increased risk of ovarian cancer among users of antidepressants, benzodiazepines, and certain other medications affecting the central nervous system has been hypothesized based on prior laboratory and epidemiologic research. We examined these associations in a case-control study. We identified 314 members of a health maintenance organization who were diagnosed with epithelial ovarian cancer between 1981--1997, were ages 35--79 at diagnosis, and had at least four years of prior membership. Using membership and billing records, up to four controls were matched to each case on calendar year, age, and length of membership (n = 790). Information regarding medication use was obtained from the institution's computerized pharmacy database, while information regarding other characteristics was obtained through medical record review.We found that compared to controls, cases were slightly less likely to have filled two antidepressant prescriptions in a six-month period (adjusted odds ratio [OR] 0.71, 95% confidence interval [CI] 0.47--1.05) or to have used an antidepressant continuously for six months or longer (OR 0.64, 95% CI 0.36--1.15). Cases were less likely than controls to have filled two benzodiazepine prescriptions in six months (OR 0.70, 95% CI 0.47--1.04) or to have used benzodiazepines continuously for six months or longer (OR 0.53, 95% CI 0.15--1.87). There was no evidence that risk of ovarian cancer increased with increasing number of prescriptions filled or pills dispensed for either antidepressants or benzodiazepines. There was no association between risk of ovarian cancer and use of medications acting via pathways involving serotonin/norepinephrine, dopamine and/or norepinephrine (DANE), or gamma-aminobutyric acid (GABA).In conclusion, our findings do not support an association between increased risk of epithelial ovarian cancer and use of antidepressants, benzodiazepines, or certain other medications acting on the central nervous system.