Neuropsychiatric Impact of Androgen Deprivation Therapy in Patients with Prostate Cancer: Current Evidence and Recommendations for the Clinician.

European Urology Focus
Aisha L SiebertAlicia K Morgans

Abstract

Although substantial literature examining the neuropsychiatric consequences of androgen deprivation therapy (ADT) exists, there are no clinical guidelines to inform providers about the specific risk of depression, suicide, and dementia for prostate cancer patients receiving chronic ADT. To evaluate the strength of the evidence and interpret the literature describing the association between ADT and psychological outcomes in men with prostate cancer. NIH/NCBI PubMed database, EMBASE, and PsychINFO were searched for articles published indexed through December 16, 2019. Results from a total of 48 recent and highly relevant articles are summarized here. ADT increased the risk of depression (relative risk [RR] 1.51, p = 0.0002), which in turn magnifies the impact of ADT-related side effects on masculine identity. ADT may be associated with increased risk of cognitive impairment, including the risk of Alzheimer's dementia in American population-based cohorts and the risk of all-cause dementia in non-American cohorts (RR 1.45, p = 0.024). Statin use and higher levels of physical activity may be protective against ADT-associated dementia. ADT increases the risk of worsening and incident depression, and may increase the risk of dementia ...Continue Reading

Citations

Jul 1, 2021·European Journal of Cancer Care·Lindsay-Jo Sevier-GuyDavid Gillanders

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