Finasteride-Induced Neuropsychiatric Reactions

The article discusses the risks associated with finasteride, particularly its potential to induce neuropsychiatric reactions such as depression and suicidal thoughts. The authors argue that the evidence supporting these risks is strong, citing studies from various countries that meet the Bradford-Hill criteria for causality. They refute claims that androgenetic alopecia (AGA) itself causes depression, emphasizing that finasteride is the likely cause. The article suggests that nonpharmacologic treatments for AGA are safer alternatives and criticizes the difficulty of conducting large-scale studies to rule out increased suicide risk. The authors call for regulatory intervention to address the market failure caused by finasteride-induced depression, which results in significant economic costs, and recommend that physicians warn patients about the drug's serious side effects.