[Rischio di trattamento]HKU School of Medicine Estimates Taking Antipsychotics May Increase Breast Cancer Risk by More Than 30% – Hong Kong Economic Times – TOPick – News – Society

▲ The research team of the Center for Drug Safety and Application Research, Department of Pharmacology and Pharmacy, Faculty of Medicine, HKU.

It is common practice to prescribe antipsychotics to patients with psychotic disorders such as schizophrenia, bipolar disorder, depression, and dementia. Numerous studies have shown that patients with schizophrenia and bipolar disorder have a higher incidence of breast cancer than the general population, or are related to the use of antipsychotic drugs. A study conducted by the University of Hong Kong estimated that taking antipsychotic drugs can increase the risk of breast cancer by more than 30%.

The research team of the Center for Drug Safety and Applied Research (CSMPR), Department of Pharmacology and Pharmacy, HKU Faculty of Medicine, conducted the world’s first systematic review and meta-analysis of observational studies involving more than 2 million people and estimated use of antipsychotics and breast cancer A moderate association of more than 30% was found among cancers, underscoring the importance of risk assessment when prescribing antipsychotics to high-risk patients.

This study included 9 observational studies involving over 2 million adults, including 5 cohort studies and 4 case-control studies, of which 7 were included in the meta-analysis. The team found that six of the studies showed that antipsychotic use was significantly associated with an increased risk of breast cancer. A meta-analysis estimated that antipsychotic users had a 30% higher risk of breast cancer and the positive association was moderate1. Evidence from some of the included reviews goes a step further, showing that prolonged use of antipsychotics, particularly those that increase prolactin, is associated with an increased risk of breast cancer. In a large case-control study in Finland that used electronic health records to compare prolonged use of antipsychotics that increase prolactin with those who took them for less than a year, people who had been taking the drugs for at least five years they were less likely to suffer from Breast cancer risk increased significantly by nearly 60%.

Although this study is limited by some unmeasured confounding factors, it still reflects that antipsychotic use may be a potential but rare adverse effect of breast cancer. The increased risk of breast cancer may be due to hyperprolactinaemia and other complications that may be associated with antipsychotics, such as central obesity, diabetes and cardiovascular disease.

Dr Tsz-chun Lai, a researcher in the Department of Pharmacology and Pharmacy, Faculty of Medicine, HKU and corresponding author of the study, said: “As the global use of antipsychotics becomes more common, including unauthorized use or off-label medications, we believe that before prescribing antipsychotics, patients should be fully clinically evaluated for their overall safety risk. “

According to the results of this study, it is advisable to avoid prescribing antipsychotic drugs with prolactin-enhancing properties to patients with breast cancer risk factors. If an antipsychotic that increases prolactin is prescribed, the patient should be advised appropriately and monitoring the patient’s prolactin level should be considered; timely treatment of antipsychotic-induced hyperprolactinaemia is critical.

The findings are now published in Epidemiology and Psychiatry.

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