Medications to shrink an enlarged prostate may contribute to depression. Doctors have not previously recognized this possible side effect for men taking prostate drugs.
What Do Prostate Drugs Do?
Drugs like dutasteride (Avodart) and finasteride (Proscar) are prescribed for benign prostate hypertrophy or BPH for short. These medicines prevent the conversion of testosterone to dihydrotestosterone. Doctors refer to these drugs as 5-alpha-reductase inhibitors, after the enzyme they affect.
Dihydrotestosterone is a metabolite of testosterone that causes prostate tissue overgrowth and male pattern baldness. Lower levels of dihydrotestosterone have been linked to fewer troublesome symptoms of BPH, such as urinary frequency or nighttime urination. Some men take these medicines to slow male pattern hair loss.
Do Men Taking Prostate Drugs Experience Psychological Side Effects?
Neurologists have become concerned that these medications do not just affect the prostate or the scalp. Reports to the FDA have raised alarms about suicide.
Depression and Suicide:
An epidemiological study of over 90,000 older Canadian men found no increased risk of suicide among men taking either finasteride or dutasteride. There was, however, an increase in depression and such men were more likely to harm themselves. The absolute risk was low, but men and their partners should be informed of this possibility.
Welk et al, JAMA Internal Medicine, online March 20, 2017
A Reader Shares His Experience with Finasteride:
Q. I took finasteride for about four months to treat BPH (benign prostate hypertrophy) and prostatitis. It gave me the worst side effects I’ve ever experienced from a prescription drug.
I had to deal with mental fog, erectile dysfunction, depression and unbelievably bad insomnia. The side effects went away after I stopped the drug. The only exception was insomnia. I needed the help of a sleep therapist to overcome that.
This drug helps some men, but health professionals should mention potential psychological as well as physical side effects. All my urologist told me was that it had a good side effect profile.
A. Urologists should now be more cautious in describing the side effect profile of finasteride (Proscar, Propecia). The European counterpart of the FDA, the European Medicines Agency (EMA), has just issued a warning about suicidal thoughts as a potential side effect of finasteride. Apparently, most cases were reported by people taking the drug to treat hair loss.
Depression is not the only troublesome side effect some men experience. For certain men, these drugs can result in sexual side effects.
Please share your own story about finasteride or dutasteride in the comment section below.
