Side Effects Of Newer Prostate Cancer Drugs Like Zytiga and Erleada Could Increase Risk of Depression: Study

The findings of a new study raise concerns about potential psychological side effects of a new generation of prostate cancer hormone drugs, indicating that medications like Xtandi, Zytiga and Erleada could increase the risk of depression.

Researchers with the University of Texas warn that second-generation antiandrogens (AAs) may be associated with a higher risk of depression among older men with prostate cancer than more traditional hormone therapy drugs. This could be the result of the androgen-depriving effects of these drugs, according to the conclusion of a study published late last month in the medical journal JAMA Network Open.

Treatment of prostate cancer often involves hormone therapy that works by depriving prostate cancer cells the hormone androgen, which promote cancer growth and progression. Antiandrogen therapy drugs, like Zytiga and Erleada, are often combined with other means of reducing androgen stimulation, which can involve medical castration, traditional hormone therapy, as well as radiation therapy.

The study warns that these newer prostate cancer antiandrogen drugs can cause a “more profound decrease in androgen signaling than prior therapies,” which could carry a greater risk of adverse effects linked to blocking and suppressing testosterone.

To investigate this potential risk, researchers conducted a retrospective cohort study involving patients 66 or older, who were diagnosed with prostate cancer without a second cancer in 12 months between January 2011 and December 2015. They looked at patients who received no hormone therapy, traditional hormone therapy or who received second-generation antiandrogens.

According to the findings, those receiving the second-generation AA drugs, like Xtandi and Zytiga, had twice the risk of developing depression than either the no hormone therapy group or the group who received traditional hormone therapy.

“Depression rates are high among patients with cancer, and depression is associated with mortality in patients with cancer and specifically among men with prostate cancer,” the researchers noted. “In our analysis, we found that across all HT exposure groups, a post-prostate cancer diagnosis of depression was associated with worse overall survival.”

They noted that interventions to reduce depression have been shown to increase survival in cancer patients.

“Considering that recipients of second-generation AAs have regular health care exposure due to the nature of their treatment, early depression screening and treatment are feasible interventions that could greatly improve their quality of life and clinical outcomes,” the researchers concluded. “The possible increased risk of depression with second-generation AA use should be discussed with patients, and depression screening should be considered in all recipients of HT, in particular those who receive second-generation AA therapies.”