Association Between Antidepressant Use and Mortality in Patients With HCC 
HCC, hepatocellular carcinoma, HCC, Comorbidity
HEPATITIS B, DISORDER, VIRUS, LIVER CIRRHOSIS, HEPATITIS C
Abbreviations: HCC, hepatocellular carcinoma; HR, hazard ratio; SSRI, selective serotonin reuptake inhibitor; SNRI, serotonin-norepinephrine reuptake inhibitor; TCA, tricyclic antidepressant.Adjusted for age, sex, low income, prediagnostic comorbidities (hepatitis B virus, hepatitis C virus, liver cirrhosis, alcohol use disorder), and Charlson Comorbidity Index score. Nonuse was defined as patients with HCC without an antidepressant prescription in the 1 year before the HCC diagnosis.Adjusted for age, sex, low income, prediagnostic comorbidities (hepatitis B virus, hepatitis C virus, liver cirrhosis, alcohol use disorder), Charlson Comorbidity Index score, and HCC treatment (operation, radiofrequency ablation, transcatheter arterial embolization/transcatheter arterial chemoembolization, radiotherapy, chemotherapy, sorafenib). Nonuse was defined as patients with HCC without an antidepressant prescription in the 1 year before and after the HCC diagnosis.False discovery rate–adjusted A similar analysis was conducted for cancer-specific mortality. The crude cancer-specific mortality rate was 0.52 per 100 person-years in the antidepressant use group and 0.42 per 100 person-years in the nonuse group. We observed that antidepressant use before HCC diagnosis did not have a significant association with lower cancer-specific mortality (adjusted HR, 1.06; 95% CI, 0.96-1.17). When examining specific subgroups of antidepressants, none of them showed an association with the lower cancer-specific mortality, with adjusted HRs ranging from 0.99 (95% CI, 0.67-1.47) to 1.13 (95% CI, 1.09-1.17) when compared with nonuse.When examining the duration of antidepressant use in the 1-year exposure window prior to HCC diagnosis, both short-term (≤90 days) and long-term (>90 days) antidepressant use displayed similar results regarding overall mortality (adjusted HR, 1.11; 95% CI, 1.09-1.14 and 1.07; 95% CI, 1.04-1.11, respectively) and cancer-specific mortality (adjusted HR, 1.08; 95% CI, 0.96-1.20 and 1.01; 95% CI, 0.84-1.22, respectively).