Posted on 09/06/2022 8:31:31 PM PDT by ConservativeMind
A research team conducted the world's first systematic review and meta-analysis of observational studies with over 2 million individuals and estimated a moderate association between antipsychotic use and breast cancer by over 30%.
Antipsychotics are commonly prescribed for patients with a range of psychiatric disorders such as schizophrenia, bipolar disorder, major depressive disorder and dementia. Elevated breast cancer incidence has been consistently reported in patients with schizophrenia and bipolar disorder, and antipsychotic use are speculated to potentially explain at least part of the increased risk. Possible mechanisms include antipsychotic-induced hyperprolactinemia, antipsychotic-mediated weight gain and poorer lifestyle among antipsychotic users. With complex mechanism and multiple interacting risk factors, the evidence of the said association remains inconclusive. Therefore, researchers from CSMPR systematically reviewed and conducted a meta-analysis to synthesize the existing evidence and determine the association between antipsychotic use and breast cancer.
This review found that six out of the nine studies had reported a significant association between the use of antipsychotic medications and an increased risk of breast cancer. The meta-analysis estimated a moderate positive association of an elevated risk of more than 30% among antipsychotic users. Some reviewed evidence further showed the extent of antipsychotic exposure, such as a longer duration of use, is associated with a higher risk of breast cancer, particularly for antipsychotics with prolactin-elevating properties. For example, a large Finnish case-control study used electronic health records to compare prolonged periods of prolactin-increasing antipsychotic use to those exposed for less than a year, which showed a significantly increased risk among those exposed for at least five years by nearly 60%.
Based on findings of this study, antipsychotics with known prolactin-elevating properties should preferably be avoided in patients with risk factors of breast cancer. Appropriate counseling is warranted before prescribing prolactin-elevating antipsychotics. Prompt management of antipsychotic-induced hyperprolactinemia is essential.
(Excerpt) Read more at medicalxpress.com ...
“Category 1 included drugs associated with high prolactin levels, such as haloperidol, paliperidone and risperidone. Category 2 drugs, which had mid-range effects on prolactin, included the drugs iloperidone, lurasidone and olanzapine. Category 3 included drugs with less of an effect on prolactin levels, such as aripiprazole, asenapine, brexpiprazole, cariprazine, clozapine, quetiapine and ziprasidone.
The researchers compared the effects of all three categories of antipsychotic drugs to anticonvulsant drugs and lithium, which also often are prescribed to treat psychiatric disorders. When compared with those drugs, the relative risk of breast cancer was 62% higher for women who took Category 1 drugs and 54% higher for those taking Category 2 drugs, whereas Category 3 antipsychotics were not associated with any increase in breast cancer risk.”
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.