Association of 5α-Reductase Inhibitors With Dementia, Depression, and Suicide

This Swedish register-based cohort study involving 2,236,876 men aged 50-90 years examined the association of 5α-reductase inhibitors (5-ARIs) with dementia, depression, and suicide. The study found that while 5-ARIs were initially associated with an increased risk of all-cause dementia, Alzheimer disease, and vascular dementia, these associations became statistically insignificant over 4 years of continuous exposure. However, both finasteride and dutasteride were consistently associated with an increased risk of depression over time, with no significant difference between the two drugs. There was no association found between 5-ARIs and suicide. The findings suggest that the initial increased risk of dementia may be due to the early detection of undiagnosed dementia, while the risk of depression remains constant. Clinicians and patients should be aware of the potential risk for depression when using 5-ARIs.