Failing Public Health Again? Analytical Review of Depression and Suicidality From Finasteride

This review examines the link between finasteride, a drug for androgenetic alopecia, and increased risks of depression and suicidality, highlighting a significant delay in recognizing these risks due to inadequate postmarketing surveillance and regulatory oversight. Despite being used by 4.6 million patients worldwide, there is significant underreporting of associated suicides, with only 320 reported by 2024 against an expected 19,320 over 30 years. The paper argues that the societal costs of depression may outweigh the drug's benefits and calls for improved pharmacovigilance, informed consent, and potentially halting finasteride's marketing for alopecia until new safety evidence is available.