To estimate the risk of incident antidepressant-treated depression in men with benign prostatic hyperplasia (BPH) who were prescribed 5-α-reductase inhibitors (5ARIs) compared with those prescribed an active comparator, α-blockers (ABs).
Retrospective cohort study with a nested case-control analysis.
United Kingdom's Clinical Practice Research Datalink.
A total of 77,732 men with a diagnosis of BPH who received a prescription for a 5ARI only and/or ABs between January 1, 1992, and December 31, 2013. Of these men, 2842 had a first-time (incident) diagnosis of depression and received a prescription for an antidepressant within 90 days of the depression diagnosis date (cases); 11,333 controls without a diagnosis of depression were matched to the cases for the case-control analysis.
Exposures were classified as 5ARI only, 5ARI+AB, or AB only. We calculated incidence rates of antidepressant-treated depression and compared rates among users of 5ARIs only and 5ARIs+ABs with rates among users of ABs only (i.e., incidence rate ratios [IRRs]). We also calculated odds ratios (ORs) to estimate the risk of incident depression with use of 5ARIs only and 5ARIs+ABs compared with ABs only. In this population of men with BPH, the risk of depression was not increased with use of 5ARIs only (IRR 0.94, 95% confidence interval [CI] 0.85-1.04) or 5ARIs+ABs (IRR 1.04, 95% CI 0.89-1.21) compared with use of ABs only. The risk of incident antidepressant-treated depression increased with longer duration of BPH, independent of study drug exposure.
In this population of men with treated BPH, use of 5ARIs, alone or in combination with ABs, did not increase the risk of incident antidepressant-treated depression compared with use of ABs only. Risk of treated depression increased with longer duration of BPH. This article is protected by copyright. All rights reserved.
Pharmacotherapy. 2017 Mar 12 [Epub ahead of print]
Katrina Wilcox Hagberg, Hozefa A Divan, J Curtis Nickel, Susan S Jick
Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, Lexington, MA, USA., New England Research Institutes, Inc.,, Watertown, MA., Kingston General Hospital, Queen's University, Kingston, ON, Canada.