Has anyone had, or know someone, who's had personality changes from taking an anti-androgen?
What were they?
For me, I felt more confident and aggressive! I'm serious! I can't say I had any personality changes, but I did notice mood changes....Like you I felt more confident, but unlike you, I didn't become more aggressive...quite the reverse. Goserelin made me MUCH calmer. and more pleasant to be around.
In fact, one of my friends said to me "If you get much more laid-back, we'll have to bring you to work on a stretcher..." ;)
One thing I did notice though; it did make me more aware of difficult situations ; walking across carparks at night, going into pubs/clubs alone, that sort of thing, made me MUCH more nervous than they had previously. Androgen ablation has been the cornerstone of treating prostate cancers that have spread beyond the confines of the gland for over 50 years. It is achieved surgically by removal of the testes, or medically with gonadotropin releasing hormone (GnRH) analogues, exogenous estrogens, anti-androgens or adrenal enzyme synthesis inhibitors. Despite this long clinical experience, controversies remain as to when androgen ablation should be initiated - early vs. late; whether the simultaneous ablation of testicular and adrenal androgens should be considered 'standard' therapy; how long to continue treating patients who are responding - until progression or in an 'off and on' or 'intermittent' fashion; and, the value of changing in hormone treatments in patients who have failed primary therapy. In general, the duration of response to first line therapy ranges from 12-18 months although upwards of 20% of patients show no biochemical or clinical evidence of relapse within 5 year follow-up. The toxicities include hot flashes, a loss of libido, impotence, fatigue, gynecomastia, softening of the skin and beard, loss of muscle tone and personality changes. Treatment with anti-androgens such as flutamide, casodex or nilutamide alone, which do not lower serum testosterone levels, are similar in toxicities except for a lower frequency of impotence. However, in several studies, anti-androgen monotherapy has been shown to be inferior to those that lower serum testosterone levels. Our general approach is to offer combined androgen blockade as initial treatment and to monitor the patient serially. Those who show a normalization of PSA have a good prognosis, while those who do not are considered for alternative therapies. |