Drugs for enlarged prostate can up depression, self-harm risk in rare case: study


TORONTO – A new study has found that a common class of medications used to treat urinary symptoms in men with an enlarged prostate does not boost the risk of suicide, but in rare cases can cause depression and thoughts of self-harm.

The drugs finasteride and dutasteride are known as 5-alpha reductase inhibitors, and concern has been raised about their potential psychiatric effects.

Senior author Dr. Blayne Welk says men with an enlarged prostate who develop depression or thoughts of self-harm after starting the drugs should speak to their doctor.

The study led by researchers at Western University in London, Ont., analyzed health data from 2003 to 2013 for about 93,000 Ontario men over age 65, and compared those taking the medications with those who were not.

Researchers found the risk of self-harm and depression equalled one extra case for every 420 men treated with one of the medications for a year, but they stressed the drugs’ potential benefits likely outweigh the risk for most patients.

The study is published in JAMA Internal Medicine.

“It is important that depression and self-harm are recognized as potential side-effects of 5ARIs,” said Welk, referring to the acronym for 5-alpha reductase inhibitors.

“However, the relatively small magnitude of these risks should not dissuade physicians from using these medications in appropriate patients.”

The study’s findings need to be assessed in younger men who take finasteride for male pattern baldness, said Welk. The medication is used in lower doses for younger men to treat hair loss and similar concerns have been raised about psychiatric side-effects in this age group.

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