Finasteride and Suicide: A Postmarketing Case Series

January 2020 in “ Dermatology ”

Michael S. Irwig

finasteride hair loss suicidal thoughts insomnia fatigue depression anxiety isolation Propecia

Studysummary This study suggests that men under 40 who develop persistent sexual side effects and insomnia after using finasteride for alopecia may be at increased risk of suicide.

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Research cited in this study

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The 5α-Reductase Inhibitor Finasteride Increases Suicide-Related Aggressive Behaviors and Blocks Clozapine-Induced Beneficial Effects in an Animal Model of Schizophrenia

research The 5α-Reductase Inhibitor Finasteride Increases Suicide-Related Aggressive Behaviors and Blocks Clozapine-Induced Beneficial Effects in an Animal Model of Schizophrenia

12 citations , April 2018 in “Physiology & Behavior”

In this study, clozapine reduced suicide-related behaviors in a schizophrenia-like mouse model, but its effects on exploratory behavior were counteracted by the neurosteroid inhibitor finasteride.

research Neuroactive Steroid Levels and Psychiatric and Andrological Features in Post-Finasteride Patients

58 citations , April 2017 in “The Journal of Steroid Biochemistry and Molecular Biology”

This study found that patients with post-finasteride syndrome exhibited major depressive disorder, severe erectile dysfunction, and neuropathy, alongside altered neuroactive steroid levels in cerebrospinal fluid.

research Association of Suicidality and Depression With 5α-Reductase Inhibitors

90 citations , March 2017 in “JAMA Internal Medicine”

In this study, older men using 5α-reductase inhibitors for prostatic enlargement did not show increased risk of suicide, but had elevated risks of self-harm and depression.

research Persistent Erectile Dysfunction in Men Exposed to 5α-Reductase Inhibitors, Finasteride, or Dutasteride

50 citations , March 2017 in “PeerJ”

This study found that longer exposure to 5α-reductase inhibitors significantly increased the risk of persistent erectile dysfunction, especially in younger men exposed to finasteride.

research Characteristics of Men Who Report Persistent Sexual Symptoms After Finasteride Use for Hair Loss

50 citations , September 2016 in “The Journal of Clinical Endocrinology and Metabolism”

This study found no evidence of androgen deficiency or decreased peripheral androgen action in men with persistent sexual symptoms after finasteride use, but identified links to depressed mood and abnormal brain function.

An Observational Retrospective Evaluation of 79 Young Men with Long-Term Adverse Effects After Use of Finasteride Against Androgenetic Alopecia

research An Observational Retrospective Evaluation of 79 Young Men with Long-Term Adverse Effects After Use of Finasteride Against Androgenetic Alopecia

43 citations , January 2016 in “International Journal of Andrology”

This study found that men experiencing long-term symptoms after finasteride use for androgenetic alopecia frequently reported loss of penis sensitivity and anhedonia, among other effects, indicating potential post-finasteride syndrome.

research Persistent Sexual Dysfunction and Suicidal Ideation in Young Men Treated with Low-Dose Finasteride: A Pharmacovigilance Study

69 citations , July 2015 in “Pharmacotherapy”

This study found that low-dose finasteride use in young men was associated with higher reporting of persistent sexual dysfunction, with some cases linked to suicidal ideation.

research Adverse Event Reporting in Clinical Trials of Finasteride for Androgenic Alopecia: A Meta-Analysis

44 citations , April 2015 in “PubMed”

This study reports that clinical trials of finasteride for androgenic alopecia provide insufficient and systematically biased safety data, with most participants unrepresentative of those in pivotal trials that led to FDA approval.

research Persistent Sexual, Emotional, and Cognitive Impairment Post-Finasteride

81 citations , June 2014 in “American Journal of Men's Health”

This study highlights that adverse effects from finasteride may persist in men after discontinuation, indicating a potential "post-finasteride syndrome.

Patients Treated for Male Pattern Hair Loss with Finasteride Show Altered Levels of Neuroactive Steroids in Cerebrospinal Fluid and Plasma After Discontinuation

research Patients Treated for Male Pattern Hair Loss with Finasteride Show Altered Levels of Neuroactive Steroids in Cerebrospinal Fluid and Plasma After Discontinuation

61 citations , April 2014 in “The Journal of Steroid Biochemistry and Molecular Biology”

This study reports that men with androgenic alopecia experience altered neuroactive steroid levels associated with persistent depression symptoms even after stopping finasteride treatment.

research The Dark Side of 5α-Reductase Inhibitors' Therapy: Sexual Dysfunction, High Gleason Grade Prostate Cancer, and Depression

75 citations , January 2014 in “Korean Journal of Urology”

This review discusses the adverse effects of 5α-reductase inhibitors, finasteride and dutasteride, on sexual, psychological, and vascular health, emphasizing the need for physicians to inform patients of these risks.

Neuroactive Steroid Levels Are Modified in Cerebrospinal Fluid and Plasma of Post-Finasteride Patients Showing Persistent Sexual Side Effects and Anxious/Depressive Symptomatology

research Neuroactive Steroid Levels Are Modified in Cerebrospinal Fluid and Plasma of Post-Finasteride Patients Showing Persistent Sexual Side Effects and Anxious/Depressive Symptomatology

73 citations , July 2013 in “The Journal of Sexual Medicine”

This study observed that androgenic alopecia patients taking finasteride had altered neuroactive steroid levels and persistent depression symptoms even after stopping the treatment.

research Depressive Symptoms and Suicidal Thoughts Among Former Users of Finasteride With Persistent Sexual Side Effects

134 citations , August 2012 in “The Journal of Clinical Psychiatry”

This study found that former finasteride users with persistent sexual side effects reported significantly higher rates of depressive symptoms and suicidal thoughts compared to controls.

research Persistent Sexual Side Effects of Finasteride for Male Pattern Hair Loss

185 citations , March 2011 in “The Journal of Sexual Medicine”

This study found that 94% of healthy men reported low libido and 92% reported erectile dysfunction as persistent sexual side effects after using finasteride for male pattern hair loss, with these effects lasting on average 40 months post-discontinuation.

Adverse Side Effects of 5α-Reductase Inhibitors Therapy: Persistent Diminished Libido, Erectile Dysfunction, and Depression in a Subset of Patients

research Adverse Side Effects of 5α-Reductase Inhibitors Therapy: Persistent Diminished Libido, Erectile Dysfunction, and Depression in a Subset of Patients

223 citations , December 2010 in “The Journal of Sexual Medicine”

This review discusses persistent adverse effects of 5α‐reductase inhibitors, like diminished libido and erectile dysfunction, in some patients and highlights the need for patient discussions before therapy, especially for androgenetic alopecia.

Finasteride Treatment Inhibits Adult Hippocampal Neurogenesis in Male Mice

research Changes in Progesterone Metabolites in the Hippocampus Can Modulate Open Field and Forced Swim Test Behavior of Proestrous Rats

269 citations , May 2002 in “Hormones and Behavior”

Lowering 3α,5α-THP in the hippocampus increases anxiety and depression in proestrous rats.