Clinical psychological evaluation in elderly men with prostatic hypertrophy in treatment with Dutasteride.

Background: Clinical psychological investigation is crucial to evaluate subject´s mental health. Neuropsychological administration explores mental status and allows to evaluate the effects of neuropathological injuries. Medical treatment of physical or mental diseases exposes subjects to possible adverse effects due to the drugs (e.g. cognitive decline, depressed mood) which could be frequent especially in elderly subjects, whom could experience a worse perceived quality of life. Benign prostatic hypertrophy (BPH) is a common disease in elderly men. 5α-reductase (5α-R) inhibitors are its treatment option and account for neuroactive steroids production. 5α-reduced steroids play a role in organs and systems function. Whether neuropsychological impairment could be due to dutasteride treatment, a 5α-R inhibitor affecting the production of dihydrotestosterone (DHT), is still unknown. The aim of the study was to investigate neuropsychological factors in men receiving dutasteride. Methods: To explore cognitive impairment and psychological factors we administered the Mini Mental State Examination, the Clock Drawing Test, the Frontal Assessment Battery, the Hamilton Anxiety Rating Scale, the Beck Depression Inventory second edition and the Short Form-12 questionnaire. Findings: Forty BPH men (mean age 71.4±7.4 yr.) assuming dutasteride showed no significant differences at the neuropsychological assessment in comparison with an agematched control group, which was not assuming dutasteride (p<0.05). No significant associations were detected between treatment duration and psychodiagnostic investigation. Discussion: This is the first study which administered a clinical psychological investigation in men with BPH in treatment with dutasteride. Our preliminary data are in accordance with the safety of dutasteride in relation to mental health.