title: Does use of tetracyclic antidepressant-mirtazapine reduce cancer risk in depression patients?
abstract: OBJECTIVE
  We conducted a nested case-control study to evaluate the association between risk of cancer and mirtazapine use in depression patients in Taiwan.
  
  
  METHODS
  We obtained data from the Taiwan National Health Insurance Research Database to conduct a population-based nested case-control study. The study cohort included 16 897 patients diagnosed with depression between January 1, 2000 and December 31, 2008. We identified 530 cancer patients as the study group and matched 4 non-cancer subjects with each cancer patient by incident density, age, and sex. Odds ratios and 95% confidence intervals were estimated using multivariate conditional logistic regression analysis.
  
  
  RESULTS
  Use of mirtazapine for depression did not have significant effect on overall cancer incidence (odds ratio: 1.03, 95% confidence interval: 0.72-1.48). Further analysis of annual mirtazapine dosages and the duration of mirtazapine use revealed no significant effect on cancer risk.
  
  
  CONCLUSIONS
  The findings of this population-based nested case-control study suggest that mirtazapine use may not provide a tumor suppression effect in humans such as that seen in the animal model. Future large-scale and in-depth investigations in this area are warranted.
authors.affiliation: Department of Radiation Oncology, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan.
authors.forename: Li-Min
authors.initials: LM
authors.lastname: Sun
authors.forename: Ming-Chia
authors.initials: MC
authors.lastname: Lin
authors.forename: Ji-An
authors.initials: JA
authors.lastname: Liang
authors.forename: Yen-Jung
authors.initials: YJ
authors.lastname: Chang
authors.forename: Shih-Ni
authors.initials: SN
authors.lastname: Chang
authors.forename: Fung-Chang
authors.initials: FC
authors.lastname: Sung
authors.forename: Chih-Hsin
authors.initials: CH
authors.lastname: Muo
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000928:Antidepressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D015897:Comorbidity; D003863:Depression / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008803:Mianserin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008875:Middle Aged; D000078785:Mirtazapine; D009369:Neoplasms / Q000453:epidemiology / Q000517:prevention & control*; D012737:Sex Factors; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents; D008803:Mianserin; D000078785:Mirtazapine
keywords: cancer; depression; mirtazapine; nested case-control study; pharmacoepidemiology