Journal article
Lack of Association between 5 alpha-Reductase Inhibitors and Depression
The Journal of urology, Vol.204(4), pp.793-798
10/01/2020
DOI: 10.1097/JU.0000000000001079
PMID: 32294395
Abstract
Purpose: Depressed mood and suicidality reported with 5 alpha-reductase inhibitors (finasteride and dutasteride) during post-marketing surveillance resulted in the addition of depression risk to finasteride labeling. As peer reviewed studies are limited and have reported mixed findings, we further evaluated 5 alpha-reductase inhibitor exposure and depression risk using sequence symmetry analysis.
Materials and Methods: National Veterans Health Administration administrative data were used to identify 53,848 male patients initiating 5 alpha-reductase inhibitor therapy during fiscal year 2014. Incident depression events were assessed separately using the 2 measures of antidepressant prescription and depression diagnosis. Symmetry ratios were calculated as the ratio of patients with an incident depression event in the year following 5 alpha-reductase inhibitor initiation to the year preceding initiation. An identical exposure counterfactual analysis was conducted among veterans initiating alpha 1-adrenergic receptor antagonists.
Results: Incident antidepressant prescribing was observed in 2,563 patients following 5 alpha-reductase inhibitor initiation and 3,051 patients preceding 5 alpha-reductase inhibitor initiation (SR 0.84, 95% CI 0.80-0.89). Similar findings were observed for incident depression diagnosis (SR 0.83, 95% CI 0.79-0.86). Stratification by age group, 5 alpha-reductase inhibitor agent, antidepressant class, prior alpha 1-adrenergic receptor antagonist exposure and depression diagnosis type failed to demonstrate any positive association between 5 alpha-reductase inhibitor and depression. Nearly identical results were observed in the alpha 1-adrenergic receptor antagonist analysis (SR 0.87, 95% CI 0.84-0.90).
Conclusions: Initiation of a 5 alpha-reductase inhibitor was not associated with increased risk of depression. Our findings support the hypothesis that depression is more likely attributable to underlying benign prostatic hyperplasia and associated lower urinary tract symptoms than 5 alpha-reductase inhibitor exposure.
Details
- Title: Subtitle
- Lack of Association between 5 alpha-Reductase Inhibitors and Depression
- Creators
- Tess E. Dyson - Iowa City VA Health Care SystemMatthew A. Cantrell - Iowa City Vet Affairs Hlth Care Syst, Dept Pharm, Iowa City, IA USABrian C. Lund - Iowa City VA Health Care System
- Resource Type
- Journal article
- Publication Details
- The Journal of urology, Vol.204(4), pp.793-798
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1097/JU.0000000000001079
- PMID
- 32294395
- ISSN
- 0022-5347
- eISSN
- 1527-3792
- Number of pages
- 6
- Grant note
- CIN 13-412 / Health Services Research and Development Service, Department of Veterans Affairs; US Department of Veterans Affairs Iowa City VA Health Care System, Department of Pharmacy Services
- Language
- English
- Date published
- 10/01/2020
- Academic Unit
- Epidemiology; Pharmacy Practice and Science
- Record Identifier
- 9984366036502771
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