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Related Experiment Video

Updated: Jan 29, 2026

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[Do benign prostatic hyperplasia drugs affect mood or cognition?]

K F Becher1, S Madersbacher2, M C Michel3

  • 1Abteilung für Geriatrie und Frührehabilitation, Helios Hanseklinikum Stralsund GmbH, Stralsund, Deutschland.

Der Urologe. Ausg. A
|February 15, 2019
PubMed
Summary

New evidence links medications for benign prostatic hyperplasia to central nervous system side effects. Physicians should monitor for cognitive decline and depression during treatment with drugs like muscarinic antagonists and 5α-reductase inhibitors.

Keywords:
5α-reductase inhibitorsCentral nervous systemMuscarinic receptor antagonistsSide effectsdementiaα1-adrenoceptor antagonists

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Area of Science:

  • Neurology
  • Pharmacology
  • Urology

Background:

  • Lower urinary tract symptoms (LUTS) are commonly associated with benign prostatic hyperplasia (BPH).
  • Pharmacological treatments for BPH include muscarinic antagonists and 5α-reductase inhibitors.
  • Central nervous system (CNS) side effects are a potential concern with these medications.

Purpose of the Study:

  • To review and discuss the risk of CNS side effects, specifically cognitive impairment/dementia and depressive symptoms.
  • To evaluate the evidence linking BPH medications to these neurological adverse events.
  • To inform clinicians about potential risks associated with LUTS treatments.

Main Methods:

  • Review of current scientific evidence and published studies.
  • Analysis of reported associations between BPH drug classes and CNS side effects.
  • Assessment of mechanistic plausibility and potential confounding factors.

Main Results:

  • Cognitive impairments are well-documented with muscarinic antagonists, with quantitative differences among agents.
  • Depressive symptoms have been consistently observed with 5α-reductase inhibitors (dutasteride and finasteride).
  • A single study suggested a possible link between tamsulosin and dementia, but this requires further investigation and may be due to bias.

Conclusions:

  • Physicians should maintain awareness of potential CNS side effects during BPH pharmacotherapy.
  • Cognitive and mood changes may necessitate medication review or adjustment.
  • Further research is needed to fully elucidate the CNS risks associated with specific BPH drugs.