The Connection of 5-Alpha Reductase Inhibitors to the Development of Depression

The review paper discusses the link between 5-alpha reductase inhibitors (5-ARIs), such as finasteride and dutasteride, and the development of depression. Several clinical studies have shown a higher incidence of depressive symptoms and neuropsychiatric side effects in former 5-ARIs users compared to non-users. Potential mechanisms include changes in neuroactive steroids, dopaminergic dysfunction, reduced hippocampal neurogenesis, increased neuroinflammation, alteration of the HPA axis, and epigenetic modifications. However, some studies found no association between 5-ARIs use and increased incidence of depression, suggesting inconsistent findings due to differences in study design and quality. The paper concludes that more research is needed to understand the underlying mechanisms of depression in former 5-ARIs patients.