title: Tricyclic antidepressants and the incidence of certain cancers: a study using the GPRD.
abstract: BACKGROUND
  Several studies suggest links between cancer and tricyclic antidepressant use.
  
  
  METHODS
  A case-control study using the General Practice Research Database examined whether previous tricyclic usage was associated with reduced incidence of brain (with glioma as a sub-category), breast, colorectal, lung and prostate cancers. Conditional logistic regression adjusted for age, gender, general practice, depression, smoking, body mass index, alcohol use and non-steroidal anti-inflammatory drug use.
  
  
  RESULTS
  A total of 31 953 cancers were identified, each matched with up to two controls. We found a statistically significant reduction in tricyclic prescriptions compared with controls in glioma (odds ratio (OR) =0.59, 95% confidence interval (CI)=0.42-0.81) and colorectal cancer patients (OR=0.84, CI=0.75-0.94). These effects were dose-dependent (P-values for trend, glioma=0.0005, colorectal=0.001) and time-dependant (P-values for trend glioma=0.0005, colorectal=0.0086). The effects were cancer-type specific, with lung, breast and prostate cancers largely unaffected by antidepressant use.
  
  
  CONCLUSIONS
  The biologically plausible, specific and dose- and time-dependant inverse association that we have found suggests that tricyclics may have potential for prevention of both colorectal cancer and glioma.
authors.affiliation: Division of Epidemiology and Public Health, School of Community Health Sciences, University of Nottingham, Nottingham NG7 2UH, UK. mcxajw2@nottingham.ac.uk
authors.forename: A J
authors.initials: AJ
authors.lastname: Walker
authors.forename: T
authors.initials: T
authors.lastname: Card
authors.forename: T E
authors.initials: TE
authors.lastname: Bates
authors.forename: K
authors.initials: K
authors.lastname: Muir
mesh_terms: D000368:Aged; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects*; D016022:Case-Control Studies; D016208:Databases, Factual; D003863:Depression / Q000139:chemically induced*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000453:epidemiology* / Q000473:pathology; D011446:Prospective Studies; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D000929:Antidepressive Agents, Tricyclic