Lack of Association between 5α-Reductase Inhibitors and Depression

Dyson, Tess E.; Cantrell, Matthew; Lund, Brian C.

doi:10.1097/ju.0000000000001079

Cited by 13 publications

(24 citation statements)

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“…79 Recent publications however have found the risk of developing depression after finasteride therapy to be low and not statistically significant. 80,81 However, more studies would be needed to validate these findings and till then it…”

Section: Adverse Effects Of Oral Finasteridementioning

confidence: 98%

“… 79 Recent publications however have found the risk of developing depression after finasteride therapy to be low and not statistically significant. 80 81 However, more studies would be needed to validate these findings and till then it would be a good practice to rule out any preexisting psychiatric issues in the patient and also consider and discuss the possible sexual side effects and risk of depression with patients prior to starting finasteride therapy. 65…”

Section: Oral Minoxidilmentioning

confidence: 99%

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Pharmacological Management of Pattern Hair Loss

Sattur

2021

Indian J Plast Surg

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Pattern hair loss (PHL) is a condition that worsens with time and the only way it can be slowed down is with pharmacological intervention. Pharmacological treatments for PHL, from an evidenced-based perspective with respect to safety and efficacy, are limited to only two drugs, minoxidil and finasteride. However, there are a host of drugs being used, off-label with limited evidence. This article attempts to review the literature on this topic, and the authors add to this, with their experience of over two decades on incorporating pharmacologic treatments along with hair transplantation in their management of PHL.

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Section: Adverse Effects Of Oral Finasteridementioning

confidence: 98%

Section: Oral Minoxidilmentioning

confidence: 99%

Pharmacological Management of Pattern Hair Loss

Sattur

2021

Indian J Plast Surg

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“…In one study examining the CCB-loop diuretic prescribing cascade, an additional medical chart review was also conducted. 107 The suspected ADRs, symptoms or new diagnoses explored were broad-ranging (see Table 2) most commonly depression (n=13) 33,37,40,45,52,55,57,73,95,99,100,112,114 ; peripheral oedema (n=11) [5][6][7]28,36,64,81,98,[105][106][107]118 ; urinary incontinence (n=9). 24,26,41,44,50,53,75,81,119 and parkinsonism (n=9) 27,29,31,46,57,81,84,123,124…”

Section: Suspected Adverse Reaction(s)mentioning

confidence: 99%

“…6,21,25,43,46,53,55,64,81,114,116,117,123,125,126 Several studies reported at least one negative association between drug pairs, indicating a reduced likelihood of the second medication being initiated (see eTable 3 Supplementary materials). 33,60,[68][69][70]75,83,89,91,95,113 Modifiers of identified associations Older people (aged [? ]65 years) were more likely to receive; i) anticholinergics for urinary incontinence following SSRI initiation, 41 ii) ulcer drug therapy within 100 days of NSAID initiation, 91 iii) diuretic to treat betablocker induced oedema, 36 and, iv) thyroxine for hypothyroidism following amiodarone initiation.…”

Section: New Medication(s) Prescribedmentioning

confidence: 99%

Prescribing cascades in community-dwelling adults: a systematic review

Doherty

Shahid

Cotter

et al. 2022

Preprint

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Background: The misattribution of an adverse drug reaction (ADR) as a symptom or illness can lead to the prescribing of additional medication, referred to as a prescribing cascade. The aim of this systematic review is to identify published prescribing cascades in community-dwelling adults. Methods: Systematic review reported in line with the PRISMA guidelines and pre-registered with PROSPERO. Electronic databases (Medline (Ovid), EMBASE, PsycINFO, CINAHL, Cochrane Library) and grey literature sources were searched. Inclusion criteria: Community-dwelling adults; Risk-prescription medication; Outcomes-initiation of new medicine to ‘treat’ or reduce ADR risk; Study type-cohort, cross-sectional, case-control and case-series studies. Title/abstract screening, full-text screening, data extraction and methodological quality assessment was conducted independently in duplicate. A narrative synthesis was conducted. Results: A total of 101 studies (reported in 103 publications) were included. Study sample sizes ranged from 126 to 11,593,989 participants and 15 studies examined older adults specifically (≥60 years). Seventy-eight of 101 studies reported a potential prescribing cascade including calcium channel blockers to loop diuretic (n=5), amiodarone to levothyroxine (n=5), inhaled corticosteroid to topical antifungal (n=4), antipsychotic to anti-Parkinson drug (n=4), and acetylcholinesterase inhibitor to urinary incontinence drugs (n=4). Identified prescribing cascades occurred within three months to one year following initial medication. Methodological quality varied across included studies. Conclusion and implications: Prescribing cascades occur for a broad range of medications. ADRs should be included in the differential diagnosis for patients presenting with new symptoms, particularly older adults and those who started a new medication in the preceding 12 months. Word count: 245

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“…The prior study [ 17 – 20 ] reported the occurrence of depression after 5ARI use, and another study [ 21 , 22 ] showed that there was no association between 5ARI use and depression. Despite that, some studies have been conducted assessing the relationship between 5ARI use and the occurrence of depression, suicide, and self-injury, there is only one population-based study in Korea on BPH patients who visited the urology department at a single university hospital [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

Depression risk associated with the use of 5α-reductase inhibitors versus α-blockers: A retrospective cohort study in South Korea

et al. 2022

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Background One of the most prescribed treatments for benign prostatic hyperplasia (BPH) is 5α-reductase inhibitors (5ARI). Europe experienced recent safety issues involving 5ARI and depression symptoms, with similar findings being seen in Western countries. The South Korea has updated the drug label in accordance with European recommendations, but the relevant evidence was insufficient. This study compared the use of 5ARI versus α-blocker (AB) as a treatment for BPH and related risks of depression to provide evidence based on the Korean population. Methods This was a retrospective cohort study using South Korea’s Health Insurance Review & Assessment Service claim data from 2011 to 2017. New patients diagnosed in men with BPH and taking medications that contained either 5ARI or AB between July 1, 2013, and June 30, 2015, were included (n = 1,461 5ARI; n = 18,650 AB). The primary outcome was depression defined per the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10: F32-34, F38, F412, F432). Logistic regression was used to implement 1:1 propensity score (PS) matching of patients taking 5ARI to those taking AB to adjust for confounding. Cox proportional hazard models were used to compare the risk of depression associated with 5ARI versus AB. Results Balance in baseline characteristics between the treatment groups were achieved within PS matched pairs (1,461 pairs). Compared to the AB medication group, the 5ARI group had lower depression (HR: 0.69, 95% CI: [0.51–0.92]). However, we could not find a clinically relevant, statistical difference after PS matching (HR: 0.91, 95% CI: [0.61–1.36]). Conclusions The risk of depression associated with 5ARI was not meaningfully different from AB in Korea, which suggests that medical officials should provide the most appropriate medication for BPH patients by considering both treatment benefits and depression risk.

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Lack of Association between 5α-Reductase Inhibitors and Depression

Cited by 13 publications

References 0 publications

Pharmacological Management of Pattern Hair Loss

Pharmacological Management of Pattern Hair Loss

Prescribing cascades in community-dwelling adults: a systematic review

Depression risk associated with the use of 5α-reductase inhibitors versus α-blockers: A retrospective cohort study in South Korea

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