Depression and androgen deprivation therapy for prostate cancer: a prospective controlled study

The main goal of this controlled study was to compare the presence of depressive symptoms and disorders in men receiving a combination of androgen deprivation therapy and radiation therapy (ADT-RTH) to men receiving RTH only.

A total of 60 men with nonmetastatic prostate cancer formed two groups: (a) ADT-RTH (n = 28) and (b) RTH only (n = 32). The ADT-RTH group was further subdivided between men who received long-term ADT (n = 17) and short-term ADT (n = 11). All participants were assessed prior to ADT initiation, and at seven additional times over a period of 16 months using semistructured interviews and self-report scales.

The prevalence of depressive disorders ranged from 5.5% to 23.0% over the study period. The introduction of ADT was associated with increases in depressive symptoms for some measures but these differences were not significant. Likewise, withdrawal of ADT was associated with consistent decreases in depressive symptoms, but none of these differences was significant. The small sample size may have limited the statistical power to detect those differences. However, calculations of effect sizes revealed that most of them were of a small magnitude.

To our knowledge, this is the first controlled study that investigated the possible role of ADT in the development of depression using prostate cancer patients who were not receiving ADT as controls. Overall, it appears that ADT does not represent a major risk factor for depression. This is good news for patients receiving this treatment who already have to adapt to many of its other side effects.