背景:如果非那雄胺,用于治疗良性前列腺增生(BPH)和雄激素性脱发(AGA)的药物,会引起精神副作用.
目的:这项基于人群的大规模研究的目的是确定非那雄胺治疗BPH和AGA是否与精神健康状况的出现有关。
方法:这项观察性病例对照研究比较了每天接受非那雄胺5mg的BPH患者和每天接受非那雄胺1mg的AGA患者与年龄和性别匹配的对照组的数据。心理健康结果的发生率,如抑郁症,焦虑,神经症,双相情感障碍,精神分裂症,非那雄胺治疗开始后2年内的精神病和酒精滥用已在非那雄胺组和对照组之间进行了评估和比较.
结果:BPH组包括307名平均年龄为61.5(±17.4)岁的男性和1218名对照组。2.3%的患者有心理健康结果,与对照组相比,速率没有显着增加。AGA组由23,227名男性组成,平均年龄为31.4(±10.3)岁,对照组为39,444名。只有1%的AGA患者出现精神疾病。与控件相比,AGA患者的焦虑和抑郁发生率较高(0.6%vs.0.4%,p=0.04,0.5%与0.4%,分别为p=0.007)。在多元回归模型中,非那雄胺被发现是焦虑(OR1.449,p=0.002)和抑郁(OR1.439,p=0.003)的危险因素之一,部门,社会经济地位和合并症。
结论:根据我们的研究,非那雄胺使用者对精神健康的不良影响率非常低,BPH患者的心理后遗症没有增加,AGA患者的焦虑和抑郁情绪略有增加。
BACKGROUND: There is a long-standing debate if finasteride, a medication used to treat benign prostatic hyperplasia (BPH) and androgenetic alopecia (AGA), can cause psychiatric side effects.
OBJECTIVE: The goal of this large-scale population-based
study was to determine whether finasteride therapy for BPH and AGA is associated with the emergence of mental health conditions.
METHODS: This observational case-control
study compared the data from patients with BPH who received finasteride 5 mg daily and patients with AGA who received finasteride 1 mg daily with age- and gender-matched controls. The incidence of psychological health outcomes such as depression, anxiety, neuroses, bipolar disorder, schizophrenia, psychoses and alcohol abuse within 2 years of the initiation of finasteride therapy has been evaluated and compared between the finasteride groups and controls.
RESULTS: The BPH group included 307 men with a mean age of 61.5 (±17.4) years and 1218 controls. Mental health outcomes recorded in 2.3% of the patients, with no significant increase in rate when compared to controls. The AGA group consisted of 23,227 men with a mean age of 31.4 (±10.3) years and 39,444 controls. Only One percent of AGA patients developed psychiatric disorders. In comparison to controls, patients with AGA had higher rates of anxiety and depression (0.6% vs. 0.4%, p = 0.04, and 0.5% vs. 0.4%, p = 0.007, respectively). In multivariate regression models, finasteride was found as one of the risk factors for anxiety (OR 1.449, p = 0.002) and depression (OR 1.439, p = 0.003) when stratified to age, sector, socioeconomic status and comorbidities.
CONCLUSIONS: According to our research, finasteride users had a very low rate of adverse mental health effects, with no increase in psychological sequelae in BPH patients and a slight increase in anxiety and depression in AGA patients.