KUO-YOU HUANGTSAI-CHING HSUBOR-SHOW TZANG2026-10-162026-10-162018-01-01Pure ID: 15171437Pure UUID: f277308d-c91e-4272-94f8-2af26a6d39e510.1002/pon.4493https://www.scopus.com/pages/publications/85040809218https://scholars.csmu.edu.tw/handle/123456789/22307Background: Hepatocellular carcinoma (HCC) is the second leading cancer-related cause of mortality worldwide. Antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), are commonly used worldwide. Available evidence investigating the association between SSRIs use and HCC risk is limited. Objective: The present study aimed to investigate if the effect of all kinds of SSRIs on HCC was the same or not using population-based study. Methods: The nationwide population-based study herein using Taiwan's National Health Insurance Research Database included a total of 59 859 cases with HCC and 285 124 matched controls. Conditional logistic regression analyses were adjusted for confounding variables. Results: All common kinds of SSRIs including fluoxetine, sertraline, paroxetine, citalopram, escitalopram, and fluvoxamine were associated with lower HCC risk, and the findings were dose-dependent (eg, fluoxetine: 1-28 DDD [defined daily dose]: adjusted odds ratio [aOR]: 0.81, 95% confidence interval [CI], 0.73-0.89; 29-365 DDD: aOR: 0.71, 95% CI, 0.64-0.79; and ≥366 DDD: aOR: 0.55, 95% CI, 0.45-0.67) (P for trend <.001). Conclusions: All kinds of SSRIs were associated with decreased risk of HCC.6enjournal article