title: Use of lithium and cancer risk in patients with bipolar disorder: population-based cohort study.
abstract: Lithium inhibits glycogen synthase kinase-3, which is an enzyme involved in the pathogenesis of cancer.
  
  
  
  To investigate the association between lithium and cancer risk in patients with bipolar disorder.
  
  
  
  A retrospective cohort study was designed using the National Health Insurance Research Database (NHIRD) in Taiwan. Patients using lithium comprised the index drug group and patients using anticonvulsants only comprised the control group. Time-dependent Cox regression was used to evaluate the hazard ratios (HRs) for risk of cancer.
  
  
  
  Compared with anticonvulsant-only exposure, lithium exposure was associated with significantly lower cancer risk (HR = 0.735, 95% CI 0.554-0.974). The hazard ratios for the first, second and third tertiles of the cumulative defined daily dose were 0.762 (95% CI 0.516-1.125), 0.919 (95% CI 0.640-1.318) and 0.552 (95% CI 0.367-0.831), respectively.
  
  
  
  Lithium is associated with reduced overall cancer risk in patients with bipolar disorder. A dose-response relationship for cancer risk reduction was observed.
authors.affiliation: Ru-Yu Huang, MSc, School of Pharmacy, Master Program in Clinical Pharmacy, Kaohsiung Medical University, Kaohsiung; Kun-Pin Hsieh, PharmD, PhD, School of Pharmacy, College of Pharmacy, Kaohsiung Medical University and Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung; Wan-Wen Huang, MSc, School of Pharmacy, Master Program in Clinical Pharmacy, Kaohsiung Medical University, Kaohsiung; Yi-Hsin Yang, PhD, School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Ru-Yu
authors.initials: RY
authors.lastname: Huang
authors.affiliation: Ru-Yu Huang, MSc, School of Pharmacy, Master Program in Clinical Pharmacy, Kaohsiung Medical University, Kaohsiung; Kun-Pin Hsieh, PharmD, PhD, School of Pharmacy, College of Pharmacy, Kaohsiung Medical University and Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung; Wan-Wen Huang, MSc, School of Pharmacy, Master Program in Clinical Pharmacy, Kaohsiung Medical University, Kaohsiung; Yi-Hsin Yang, PhD, School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Kun-Pin
authors.initials: KP
authors.lastname: Hsieh
authors.affiliation: Ru-Yu Huang, MSc, School of Pharmacy, Master Program in Clinical Pharmacy, Kaohsiung Medical University, Kaohsiung; Kun-Pin Hsieh, PharmD, PhD, School of Pharmacy, College of Pharmacy, Kaohsiung Medical University and Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung; Wan-Wen Huang, MSc, School of Pharmacy, Master Program in Clinical Pharmacy, Kaohsiung Medical University, Kaohsiung; Yi-Hsin Yang, PhD, School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Wan-Wen
authors.initials: WW
authors.lastname: Huang
authors.affiliation: Ru-Yu Huang, MSc, School of Pharmacy, Master Program in Clinical Pharmacy, Kaohsiung Medical University, Kaohsiung; Kun-Pin Hsieh, PharmD, PhD, School of Pharmacy, College of Pharmacy, Kaohsiung Medical University and Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung; Wan-Wen Huang, MSc, School of Pharmacy, Master Program in Clinical Pharmacy, Kaohsiung Medical University, Kaohsiung; Yi-Hsin Yang, PhD, School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan yihsya@kmu.edu.tw.
authors.forename: Yi-Hsin
authors.initials: YH
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000494:pharmacology; D018692:Antimanic Agents / Q000494:pharmacology*; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D018020:Lithium Compounds / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000517:prevention & control*; D012042:Registries / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012306:Risk; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D018692:Antimanic Agents; D018020:Lithium Compounds