Finasteride-Associated Suicide and Depression in Men Treated for Hypogonadism and Impotence

This study analyzed data from VigiBase to assess the psychological adverse events associated with finasteride use in men treated for hypogonadism and sexual dysfunction. The study found 611 reports of suicidality, 2,352 reports of anxiety disorders, and 2,392 reports of depressed mood disorders among finasteride users, with a significant increase in suicidality risk (ROR 1.89) when finasteride was used alone. However, the risk decreased when finasteride was combined with phosphodiesterase 5 inhibitors (PDE5i) or testosterone. The combination with PDE5i notably reduced the risk of anxiety and depression. The findings suggest that treating underlying hypogonadism or sexual dysfunction may mitigate the psychological risks associated with finasteride use for alopecia or benign prostatic hyperplasia (BPH).