Table 1: Androgen deprivation therapies: site(s) of activity, hormonal effects and reflex increases
| Treatment | Drug names | Site(s) | Primary Hormonal Effect | Reflex changes |
|---|---|---|---|---|
| Orchiectomy | Testicles | 4: decreases T | LHRH, LH, FSH | |
| LHRH agonist | Lupron, Zoladex | Pituitary | 2: decreases LH, FSH | |
| LHRH + Anti-androgen(AA) | Above + Flutamide or Casodex, or Nilutamide | Pituitary, Prostate cell nucleus | 2: as above 9: decrease in T and DHT binding to androgen response elements in nucleus | ? ACTH ? DHEA ? Andro-stenedione |
| LHRH + Anti-androgen + 5AR inhibitor | Above + Proscar(Finasteride) | Pituitary, Prostate cell cytoplasm, nucleus | 2: as above 9: as above 8: 5 alpha reductase inhibitor | Same as above |
| Anti-androgen | Flutamide, Casodex, Nilutamide | Prostate cell nucleus | 9: as above | LHRH, LH, T, DHT,E |
| Anti-androgen + 5AR inhibitor | Above + Proscar | Prostate cell cytoplasm, nucleus | 9: as above 8: as above | LHRH, LH, T & E |
| Estrogens | DES, estradiol, Stilphosterol Honvan | Hypo- thalamus Prostate cell | 1: decreases LHRH 2: LH, FSH 4: T direct cytotoxic effect | Prolactin |
| Ketoconazole | Nizoral | Adrenal glands Testicles Prostate cell | 5-7: decreases adrenal androgens 4: decreases T direct cytotoxic effect | LHRH, LH, & FSH ACTH |
| Steroids | Hydro- cortisone Decadron | Pituitary Adrenal glands | 3: decreases ACTH | Decreases CRF and ACTH |
| Aminoglut- ethemide with steroids | Cytadren Hydro- cortisone | Pituitary Adrenal glands | 3: decreases ACTH 5-7: decreases adrenal androgens | ? LHRH & LH |