Use of 5α-reductase inhibitors (5-ARIs) for the treatment of BPH appears to be associated with increased risks of self-harm and depression, according to a population-based, retrospective, matched cohort study of men in Canada.
The research, which was recently published in JAMA Internal Medicine (2017; 177:683-91), included 93,197 men who filled a prescription for finasteride (Proscar) or dutasteride (Avodart) and an equally sized, propensity score-matched, unexposed cohort.
Suicide was investigated as the primary outcome. Its absolute risk was 0.04% in both groups with no statistically significant increase in risk in the 5-ARI group.
Also see - Why men are not immune to eating disorders
Self-harm and incident depression were analyzed as secondary outcomes, and during the first 18 months after treatment initiation, the risk of each of these events was significantly increased by nearly twofold among men using a 5-ARI compared with the unexposed controls. Longer use of a 5-ARI was only associated with an increased risk of incident depression, although the level of risk was lower than during the first 18 months after treatment initiation.
For self-harm, the absolute increase in rate in the 5-ARI group was 17 per 100,000 patient-years, and for depression, it was 237 per 100,000 patient-years. Risks for suicide, self-harm, and incident depression were similar in subgroup analyses that separately considered men using finasteride or dutasteride.