Hormone therapy associated with increased risk of depression

This study examined the effect of androgen deprivation therapy (ADT) on clinical depression. Authors reported that ADT increased the risk of depression and the need for psychiatric treatment. The risk of depression increased with duration of ADT.

ADT is a type of hormone therapy commonly used to treat prostate cancer. It targets the production of male hormones (such as testosterone) and reduces their effect on cancer cell growth. Reducing androgen levels can dramatically improve survival among prostate cancer patients.

ADT can cause significant side effects in some patients. These can affect bone health, heart health, and metabolic factors (such as weight gain, cholesterol levels, and diabetes risk). It has been suggested that ADT may also impact mood and cause clinical depression. However, the evidence for this is mixed, with some studies reporting no effect. Larger studies are needed to investigate the link between ADT and depression. A better understanding of this link may improve both treatment and quality of life.

This study followed 78,552 men aged 66 years or older with localized (confined) prostate cancer. 43.1% of men underwent ADT drug therapy within 6 months of prostate cancer diagnosis. ADT was administered either alone (29.1%) or in addition to surgery (6%) or radiation therapy (64.9%). Duration of ADT was either less than 6 months (45.3%), between 7 and 11 months (22.1%), or more than 12 months (32.6%). 56.9% of men did not undergo any ADT. The rates of depression were compared between men who received ADT and those that did not. Patients were followed for up to 36 months.

7.1% of men receiving ADT showed clinical depression during the study follow-up. This was significantly higher than the 5.2% of men not undergoing any ADT who experienced depression. Psychiatric inpatient and outpatient treatment for depression was also significantly more common among men undergoing ADT. Overall, the risk of depression was 23% higher for men receiving ADT.

The risk of depression significantly increased with duration of ADT. Depression rates increased from 12% with 6 months of ADT, to 26% with 7 to 11 months, and to 37% with more than 12 months of ADT. Older age, being unmarried, and having other medical conditions were also associated with an increased depression risk. 

This study concluded that the risk of depression and psychiatric treatment of depression is increased in men undergoing ADT. The risk of depression increased with duration of ADT.

Discuss with your doctor the possible side effects of ADT.