The depressive effects of androgen deprivation therapy in locally advanced or metastatic prostate cancer: a comparative study

Abstract

Aim To investigate association of androgen deprivation therapy (ADT) with depression and the effect of depression on cognitive functions in men with locally advanced or metastatic prostate cancer. Methods A total of 144 patients were evaluated in a prospective, comparative study. Group1 consisted of 72 patients with locally advanced or metastatic prostate cancer who received complete ADT treatment continuously for 12 months and group2 (control group) consisted of 72 patients who underwent radical prostatectomy without any additional treatment. MoCA (The Montreal Cognitive Assessment) and HAM-D (Hamilton depression rating scale) tests were used to assess the effects of ADT on depression and cognitive functions. Results According to post-treatment results of MoCA test, patients had lower mean total scores in both the groups. The deficits were especially prominent in the areas of language ability and short-term memory capacity. In the comparison of two groups according to HAM-D tests, the scores were significantly higher in group1 at baseline-6 month, at baseline-12 month and at 6–12 month follow-up period (p = .003, p < .001, p = .023).There was a relationship between depression and deterioration of language and memory functions at 6th (p < .001, p = .002) and 12th months (p < .001, p = .046). Attention function was deteriorated in these patients at 6th (p < .001) and 12th months (p < .001). Conclusions ADT causes increase in depression and the deterioration of cognitive functions. ADT should be given carefully to these older group of patients with concomitant morbidities.