Can We Identify a Post-Serenoa Syndrome (PSS)? A Case Series on Sexual and Psychiatric Side Effects of Serenoa Repens

    January 2026 in “ British Journal of Clinical Pharmacology ”
    Filippo Firenzuoli, Filippo Firenzuoli, Bernardo Firenzuoli … Katia Belvedere
    Studysummary In this study, reports from individuals using Serenoa repens indicated a possible post-Serenoa syndrome characterized by persistent sexual and neuropsychiatric symptoms, with causality assessed as 'probable' in 54% of cases, highlighting an underrecognized safety concern that warrants further investigation.
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    Research cited in this study 14

    1. Post-Finasteride Syndrome and Post-SSRI Sexual Dysfunction: Two Clinically Similar Conditions Frontiers in Neuroendocrinology · 2023
    2. Suspected Adverse Reactions to Medications and Food Supplements Containing Serenoa Repens: A Worldwide Analysis of Pharmacovigilance and Phytovigilance Spontaneous Reports Phytotherapy Research · 2023
    3. US Food and Drug Administration Warning Regarding Finasteride and Suicidal Ideation: What Should Urologists Know? European urology open science · 2023
    4. Association of 5α-Reductase Inhibitors With Dementia, Depression, and Suicide JAMA network open · 2022
    5. Gut Inflammation Induced by Finasteride Withdrawal: Therapeutic Effect of Allopregnanolone in Adult Male Rats Biomolecules · 2022
    6. Serenoa Repens Induced Erectile Dysfunction: Underdiagnosis and Phytovigilance British Journal of Clinical Pharmacology · 2021
    7. Treatment Options for Androgenetic Alopecia: Efficacy, Side Effects, Compliance, Financial Considerations, and Ethics Journal of Cosmetic Dermatology · 2021
    8. The Connection of 5-Alpha Reductase Inhibitors to the Development of Depression Biomedicine & Pharmacotherapy · 2021
    9. Risk of Depression Associated with Finasteride Treatment Journal of Clinical Psychopharmacology · 2021
    10. Investigation of Suicidality and Psychological Adverse Events in Patients Treated With Finasteride JAMA Dermatology · 2020
    11. Finasteride and Suicide: A Postmarketing Case Series Dermatology · 2020
    12. Post-Finasteride Syndrome: An Emerging Clinical Problem Neurobiology of Stress · 2019
    13. An Overview of Herbal Alternatives in Androgenetic Alopecia Journal of Cosmetic Dermatology · 2019
    14. The Influence of Low Dose Finasteride, a Type II 5α-Reductase Inhibitor, on Circulating Neuroactive Steroids Hormone Molecular Biology and Clinical Investigation · 2009