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Oral Finasteride and Neuropsychiatric Side Effects: A Summary of Recent Findings

- In: Clinical Practice, Professional Development

Multiple clinical studies suggest a potential link between oral finasteride and neuropsychiatric side effects, including depression and suicidal behavior. A systematic review indicated that finasteride users were significantly more likely to experience depressive symptoms (3.33%) compared to non-users (2.54%). The risk of suicidal ideation or behavior was also higher among finasteride users (21.2%) versus non-users (14.0%).

Reports have highlighted that nearly 50% of men experiencing post-finasteride syndrome (PFS) report clinically significant depression. However, a recent study found no increased risk of suicidal behavior in males treated for benign prostatic hyperplasia (BPH) with finasteride, compared to those on dutasteride, especially in men without a psychiatric history. In contrast, males with prior mood disorders may face a higher risk of suicide or self-harm with finasteride.

The study also examined the FDA Adverse Event Reporting System (FAERS) database for signals of neuropsychiatric adverse events (AEs) linked to finasteride. No signals were found between 2006 and 2011, but signals appeared from 2013 onwards, aligning with greater public awareness following the 2012 FDA update about PFS and increasing media attention. Interestingly, oral dutasteride did not show similar signals, suggesting that the reports of finasteride-related neuropsychiatric AEs may be influenced by reporting bias.

The study emphasizes that while the FAERS database can help identify safety signals, it has limitations, including under-reporting and inconsistent data. Nevertheless, healthcare professionals should screen patients for mood changes, depression, and suicidal thoughts before prescribing finasteride and monitor them regularly for adverse effects. Males with a history of mood disorders may need special consideration or closer supervision when using finasteride.

For a link to the original full article, click here.

 

Elevate-Derm Alliance Editorial Board