Post-Finasteride Syndrome and Post-SSRI Sexual Dysfunction: Two Clinically Similar Conditions

November 2023 in “ Frontiers in Neuroendocrinology ”

Silvia Giatti, Silvia Diviccaro, Lucia Cioffi, Roberto Cosimo Melcangi

finasteride post-finasteride syndrome SSRI antidepressants post-SSRI sexual dysfunction sexual dysfunction psychological issues sleep disorders brain modulators neurotransmitters gut microbiota steroids nervous system gut-brain axis Propecia PFS PSSD

TLDR Some people experience lasting sexual, psychological, and sleep problems after using finasteride or SSRI antidepressants, possibly due to similar underlying causes.

The document discusses the persistent side effects of two drugs, finasteride and SSRI antidepressants, even after discontinuation, leading to conditions known as post-finasteride syndrome (PFS) and post-SSRI sexual dysfunction (PSSD). These side effects include sexual dysfunction, psychological issues, and sleep disorders. The paper suggests that these conditions may share common pathological mechanisms, involving brain modulators, neurotransmitters, and gut microbiota. The role of steroids is also highlighted, as they can affect the nervous system and are involved in the gut-brain axis. The document concludes that more research is needed to better understand these conditions and develop effective diagnostic markers and therapeutic strategies.

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research The Post-Finasteride Syndrome: Possible Etiological Mechanisms and Symptoms

3 citations , September 2023 in “International journal of impotence research”

Post-finasteride syndrome causes lasting sexual, mental, and physical issues, needing more research for solutions.

research Exploring Rat Corpus Cavernosum Alterations Induced by Finasteride Treatment and Withdrawal

1 citations , August 2023 in “Andrology”

Finasteride changes hormone levels and certain proteins in rats, but these effects can be reversed after stopping the drug.

research Pregnenolone for the Treatment of L-DOPA-Induced Dyskinesia in Parkinson's Disease

2 citations , May 2023 in “Experimental neurology”

Pregnenolone might help manage movement issues caused by Parkinson's disease treatment without reducing the medicine's effectiveness.

research Gut Inflammation Induced by Finasteride Withdrawal: Therapeutic Effect of Allopregnanolone in Adult Male Rats

October 2022 in “Biomolecules”

research Global Online Interest in Finasteride Sexual Side Effects

September 2022 in “International Journal of Impotence Research”

research Diagnostic Criteria for Enduring Sexual Dysfunction After Treatment With Antidepressants, Finasteride, and Isotretinoin

8 citations , January 2022 in “The international journal of risk and safety in medicine”

research Exploring the Impact of the Microbiome on Neuroactive Steroid Levels in Germ-Free Animals

11 citations , November 2021 in “International journal of molecular sciences”

Gut microbes significantly affect brain steroid levels.

research Differential Gene Expression in Post-Finasteride Syndrome Patients

2 citations , July 2021 in “The Journal of Sexual Medicine”

research Alterations of Gut Microbiota Composition in Post-Finasteride Patients: A Pilot Study

17 citations , June 2021 in “Journal of Endocrinological Investigation”

Post-finasteride patients show changes in gut bacteria, possibly causing various symptoms.

research Three-Dimensional Proteome-Wide Scale Screening for the 5-Alpha Reductase Inhibitor Finasteride: Identification of a Novel Off-Target

3 citations , April 2021 in “Journal of Medicinal Chemistry”

Finasteride may affect PNMT, causing side effects.

research Case Report: A Study of the Clinical Characteristics and Genetic Variants of Post-Finasteride Syndrome Patients

January 2021 in “Translational Andrology and Urology”

research Penile Vascular Abnormalities in Young Men with Persistent Side Effects After Finasteride Use for the Treatment of Androgenic Alopecia

7 citations , June 2020 in “Translational Andrology and Urology”

Finasteride for hair loss may cause lasting sexual, genitourinary, mental, and anti-androgenic side effects in young men.

research Post-Finasteride Syndrome: An Emerging Clinical Problem

26 citations , May 2020 in “Neurobiology of Stress”

Post-finasteride syndrome causes lasting sexual, neurological, and physical side effects in some people after taking finasteride.

research Post-Finasteride Syndrome: A Surmountable Challenge for Clinicians

30 citations , January 2020 in “Fertility and Sterility”

research Altered Methylation Pattern of the SRD5A2 Gene in the Cerebrospinal Fluid of Post-Finasteride Patients: A Pilot Study

8 citations , August 2019 in “Endocrine connections”

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research Finasteride and Erectile Dysfunction in Patients with Benign Prostatic Hyperplasia or Male Androgenetic Alopecia

20 citations , May 2019 in “The World Journal of Men's Health”

Finasteride may increase erectile dysfunction risk in patients with benign prostatic hyperplasia.

research Treatment of Male Rats with Finasteride, an Inhibitor of 5alpha-Reductase Enzyme, Induces Long-Lasting Effects on Depressive-Like Behavior, Hippocampal Neurogenesis, Neuroinflammation, and Gut Microbiota Composition

37 citations , January 2019 in “Psychoneuroendocrinology”

Finasteride treatment in male rats causes long-lasting effects on depression-like behavior, brain cell growth, inflammation, and gut bacteria composition.

research A Review of the FAERS Data on 5-Alpha Reductase Inhibitors: Implications for Postfinasteride Syndrome

35 citations , October 2018 in “Urology”

The review suggests younger men taking 1 mg finasteride report more side effects, including sexual, skin, metabolic, and psychological issues.

research Enduring Sexual Dysfunction After Treatment With Antidepressants, 5α-Reductase Inhibitors, and Isotretinoin: 300 Cases

54 citations , June 2018 in “International journal of risk & safety in medicine”

Antidepressants, 5α-reductase inhibitors, and isotretinoin can cause long-lasting sexual dysfunction.

research Post-Finasteride Syndrome and Post-SSRI Sexual Dysfunction: Two Sides of the Same Coin?

40 citations , April 2018 in “Endocrine”

PFS and PSSD are similar conditions with persistent sexual dysfunction after stopping medication.

research Drug Treatment for Androgenetic Alopecia: First Italian Questionnaire Survey on Dermatologists' Opinions about Finasteride

7 citations , March 2018 in “Dermatology and therapy”

Finasteride is considered the best treatment for hair loss, despite side effects.

research Research Brief: Self-Reports of Persistent Antiandrogenic, Estrogenic, Physical, and Psychological Effects of Finasteride Usage Among Men

9 citations , January 2018 in “American Journal of Men's Health”

Finasteride use can cause lasting negative effects like sexual dysfunction, depression, anxiety, and cognitive issues.

research Sexual Side Effects of 5-Alpha-Reductase Inhibitors Finasteride and Dutasteride: A Comprehensive Review

21 citations , November 2017 in “Dermatology Online Journal”

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

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

Post-finasteride patients show changed neuroactive steroid levels, possibly causing erectile dysfunction and depression.

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

90 citations , May 2017 in “JAMA Internal Medicine”

Men over 66 taking medication for prostate enlargement have a higher risk of depression and self-harm, especially in the first 18 months of treatment.

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

50 citations , March 2017 in “PeerJ”

Using finasteride or dutasteride may cause long-lasting erectile dysfunction.

research Androgen Receptor (AR) Gene (CAG)n and (GGN)n Length Polymorphisms and Symptoms in Young Males With Long-Lasting Adverse Effects After Finasteride Use Against Androgenic Alopecia

14 citations , March 2017 in “Sexual Medicine”

Finasteride side effects in young men may be linked to specific gene variations.

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8 citations , February 2017 in “Clinical Drug Investigation”

Finasteride can cause sexual dysfunction and depression, which may persist and require hormonal treatment.

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”

Finasteride for hair loss may cause persistent sexual symptoms, depression, anxiety, and lower quality of life.

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32 citations , September 2016 in “Journal of Dermatology”

Dutasteride safely promotes hair growth and reduces hair loss, with mild side effects.

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19 citations , August 2016 in “Annals of Dermatology”

Dutasteride is safe and effective for treating hair loss, but may decrease libido.

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

Finasteride caused long-term sexual and non-sexual side effects in young men with hair loss.

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33 citations , January 2016 in “Skin appendage disorders”

The document concludes that sexual and psychiatric side effects from 5-alpha-reductase inhibitors are reported, but more high-quality research is needed to understand how often they occur.

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33 citations , January 2016 in “Neuroendocrinology”

Finasteride treatment changes brain steroid levels and receptors, affecting brain function even after stopping treatment.

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31 citations , September 2015 in “The Journal of Steroid Biochemistry and Molecular Biology”

Neuroactive steroids could become safe, effective treatments with more understanding of their complex brain actions and metabolism.

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44 citations , June 2015 in “PubMed”

Finasteride for hair loss may cause long-lasting side effects like impotence and low libido, but trials lack proper safety reporting.

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

81 citations , May 2015 in “American Journal of Men's Health”

Finasteride can cause lasting sexual, emotional, and cognitive issues, with varying severity.

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 , February 2015 in “The Journal of Steroid Biochemistry and Molecular Biology”

Finasteride affects brain and blood steroids, causing lasting sexual and emotional side effects.

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16 citations , December 2014 in “International Journal of Biological Markers”

Longer CAG and GGN repeats increase alopecia risk, but no significant link to post-finasteride syndrome found.

research Androgen Levels and Semen Parameters Among Former Users of Finasteride With Persistent Sexual Adverse Effects

15 citations , December 2014 in “JAMA Dermatology”

research Immunohistochemical Evaluation of Androgen Receptor and Nerve Structure Density in Human Prepuce from Patients with Persistent Sexual Side Effects after Finasteride Use for Androgenetic Alopecia

36 citations , June 2014 in “PLOS ONE”

Finasteride, a hair loss drug, may cause long-term sexual side effects due to changes in hormone receptor levels.

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 , October 2013 in “The Journal of Sexual Medicine”

Finasteride use changes brain chemicals, causing lasting sexual issues and anxiety/depression.

research A Pilot Study on the Sexual Side Effects of Finasteride as Related to Hand Preference for Men Undergoing Treatment of Male Pattern Baldness

19 citations , April 2013 in “BJUI”

Left-handed men experience more sexual side effects from finasteride treatment.

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Finasteride may cause long-lasting sexual side effects.

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

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Former finasteride users with persistent sexual side effects have higher rates of depression and suicidal thoughts.

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

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Finasteride for hair loss can cause long-lasting sexual side effects like low libido and erectile dysfunction.

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24 citations , January 2010 in “Endocrine Regulations”

Taking 1mg of finasteride daily can mildly improve metabolic health and glucose regulation in men with male pattern baldness.

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Dutasteride more effectively lowers DHT levels in men with enlarged prostates than finasteride.

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Finasteride for hair loss may cause depression, affecting sleep and relationships.

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Finasteride safely and effectively treats male pattern hair loss, but may cause reversible sexual issues and harm male fetuses.

8 / 8 results

research Finasteride for Androgenetic Alopecia Is Not Associated with Sexual Dysfunction: A Survey-Based, Single-Centre, Controlled Study

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research Pharmacovigilance Analysis of Reports of Sexual Dysfunction Associated with Finasteride Use: Implications for the Post-Finasteride Syndrome

May 2022 in “The Journal of Sexual Medicine”

research Pharmacovigilance Analysis of Reports of Sexual Dysfunction Associated with Finasteride Use: Implications for the Post-Finasteride Syndrome

April 2022 in “The Journal of Sexual Medicine”

research Finasteride for Androgenetic Alopecia Is Not Associated with Sexual Dysfunction: A Survey-Based, Single-Centre, Controlled Study

18 citations , July 2019 in “Journal of The European Academy of Dermatology and Venereology”

Finasteride use doesn't cause sexual dysfunction in men with hair loss.

research Finasteride for Androgenetic Alopecia Is Not Associated with Sexual Dysfunction: A Survey-Based, Single-Center, Controlled Study

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