A new study which analyzed Medicare claims over a period of 6 years from 2006 to 2012 has uncovered a startling link between the most common pharmaceutical drugs used to treat BPH and cognitive decline.
Clinicians commonly prescribe adrenergic antagonists called alpha blockers to manage lower urinary tract symptoms in older men suffering from BPH. Though they can sometimes cause inconvenient side effects such as increased risk of urinary incontinence, these drugs are often the preferred medical treatment for BPH since they are generally well tolerated and reasonably affordable.
However, a 2018 cohort study released in the New England Journal of Medicine has indicated these same drugs have the potential to severely impair cognitive function. Researchers found that the cohort of 253,136 men taking the alpha blocker tamsulosin were nearly 21% more likely to develop dementia compared to the cohort of 180,926 men who did not take any medication for BPH. The men taking tamsulosin were also much more likely to be diagnosed with dementia when compared with men taking other classes of BPH drugs, such as alpha-reductase inhibitors like dutasteride or finasteride. The median follow-up period for all cohorts in the study was just 19.8 months, indicating that the onset of these cognitive changes were rapid.
Some experts have rushed to the defense of tamsulosin, the top selling BPH medication on the market, suggesting that the drug has shown limited ability to cross the blood-brain barrier. If this compound can only minimally penetrate into the brain, they say, how could it possibly cause such a sudden onset of dementia? In addition, another study in 2020 was conducted which found that tamsulosin did not worsen cognitive scores for elderly men with Alzheimer's disease. Nevertheless, the 2018 study's statistical analysis is sound, and it is causing many physicians to reevaluate the safety of the drug.
Currently, the FDA still considers tamsulosin as safe, effective, and well-tolerated. However, if you are taking tamsulosin or have a prostate issue, it may be best to consider discussing the pros and cons of the medication with your doctor.
