Risperidone Exposure and Breast Cancer Risk: A Cohort Study Using the Taiwan National Health Insurance Research DatabaseAuthor(s): Kuan-Yi Tsai, Hung-Chi Wu, Shih-Pei Shen, Hong Qiu, Yiting Wang, Helen Pai, Yu-Mei Chou, Frank Huang-Chih Chou
Conventional (typical) antipsychotics are thought to be associated with the development of breast cancer (BC) due to their dopamine-antagonistic effects that lead to increased circulating prolactin. Atypical antipsychotics, particularly risperidone and paliperidone may also increase prolactin secretion. We investigated whether risperidone use was associated with an increased BC risk by estimating the incidence of BC in users of risperidone, other atypical antipsychotics, and conventional antipsychotics.
This retrospective cohort study used data from Taiwan’s Nation Health Insurance Research Database (NHIRD) which captures claims from mandatory universal health insurance in Taiwan. All women aged ≥18 years who initiated treatment with any antipsychotic between July 2000-December 2011 were identified in the database. BC was identified from the NHIRD Registry of Catastrophic Illness and Taiwan Cancer Registry. Cox proportional hazards models were used to adjust for potential confounders and compare BC incidence among the three antipsychotic exposure groups.
There were 233,237 women included in the total cohort analysis. The mean follow-up period was 3.34-5.56 years. Crude incidence rates of BC were 123.1 per 100,000 person-years in the risperidone group, 135.7 per 100,000 person-years in the other atypical group and 149.8 per 100,000 person-years in the typical group. The adjusted hazard ratio was 1.13 (95%CI 0.98-1.29) and 1.07 (95%CI 0.95-1.22) comparing the other atypical and the typical groups, respectively with the risperidone group.
There is no evidence of an increased risk of BC associated with risperidone compared to other atypical or conventional antipsychotics.