Widely used mental health drugs may increase breast cancer risk

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Antipsychotics are commonly prescribed for patients with a range of psychiatric disorders such as schizophrenia, bipolar disorder, major depressive disorder and dementia.

A recent study from The University of Hong Kong found the use of antipsychotic drugs is linked to a higher breast cancer risk.

They reviewed studies with over 2 million individuals and estimated a moderate association between antipsychotic use and breast cancer by over 30%.

This highlights the importance of the risk-benefit assessment of antipsychotic prescriptions in high-risk patients.

Elevated breast cancer incidence has been consistently reported in patients with schizophrenia and bipolar disorder, and antipsychotic use is 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.

In the study, researchers aimed to synthesize the existing evidence and determine the association between antipsychotic use and breast cancer.

Nine studies with over 2 million adults, including five cohort and four case-control studies, were included for the review and seven for the meta-analysis.

The team found that six out of the nine studies had reported a strong 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, one study compared 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%.

The current research highlights that breast cancer could be a potential but rare adverse event of antipsychotic medications.

The elevated breast cancer risk may be explained by hyperprolactinemia and other complications possibly induced by antipsychotics, such as central obesity, diabetes and heart disease.

The study was conducted by Dr. Francisco Lai Tsz-tsun et al and published in Epidemiology and Psychiatric Sciences.

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