Brain, mind & behavior

General

Magri ML, Gottardo MF, Zárate S, et al. Opposite effects of dihydrotestosterone and estradiol on apoptosis in the anterior pituitary gland from male rats. Endocrine. 2016. doi:10.1007/s12020-015-0719-2 • PubMed

Behavior & stress response

Animal studies

Bartolomé I, Llidó A, Darbra S, Pallarès M. Early postnatal allopregnanolone levels alteration and adult behavioral disruption in rats: Implication for drug abuse. Neurobiol Stress. 2019. doi:10.1016/j.ynstr.2019.100208 • PubMed

Dhillon HK, Singh T, Goel RK. Ferulic acid inhibits catamenial epilepsy through modulation of female hormones. Metab Brain Dis. 2022. doi:10.1007/s11011-022-01054-w • PubMed [Finasteride increased seizure susceptibility and depression-like characteristics]

Diviccaro S, Giatti S, Borgo F, et al. 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. Psychoneuroendocrinology. 2019. doi:10.1016/j.psyneuen.2018.09.021 • PubMed

Frau R, Pillolla G, Bini V, Tambaro S, Devoto P, Bortolato M. Inhibition of 5α-reductase attenuates behavioral effects of D1-, but not D2-like receptor agonists in C57BL/6 mice. Psychoneuroendocrinology. 2013. doi:10.1016/j.psyneuen.2012.07.014 • PubMed

Godar SC, Cadeddu R, Floris G, et al. The steroidogenesis inhibitor finasteride reduces the response to both stressful and rewarding stimuli. Biomolecules. 2019. doi:10.3390/biom9110749 • PubMed

Li L, Kang YX, Ji XM, et al. Finasteride inhibited brain dopaminergic system and open-field behaviors in adolescent male rats. CNS Neurosci Ther. 2018. doi:10.1111/cns.12781

Mann PE. Finasteride delays the onset of maternal behavior in primigravid rats. Physiol Behav. 2006. doi:10.1016/j.physbeh.2006.04.008 • PubMed

Maurice-Gélinas C, Deslauriers J, Monpays C, Sarret P, Grignon S. The 5α-reductase inhibitor finasteride increases suicide-related aggressive behaviors and blocks clozapine-induced beneficial effects in an animal model of schizophrenia. Physiol Behav. 2018. doi:10.1016/j.physbeh.2018.03.036 • PubMed

Soggiu A, Piras C, Greco V, et al. Exploring the neural mechanisms of finasteride: a proteomic analysis in the nucleus accumbens. Psychoneuroendocrinology. 2016. doi:10.1016/j.psyneuen.2016.10.001 • PubMed

Cognition & memory

↑ back to top

Original investigation

Ganzer CA, Jacobs AR, Iqbal F. Persistent sexual, emotional, and cognitive impairment post-finasteride: a survey of men reporting symptoms. Am J Mens Health. 2015. doi:10.1177/1557988314538445 • PubMed

Cohort studies

Garcia-Argibay M, Hiyoshi A, Fall K, Montgomery S. Association of 5α-reductase inhibitors with dementia, depression, and suicide. JAMA Netw Open. 2022. doi:10.1001/jamanetworkopen.2022.48135PubMed

Welk B, McArthur E, Ordon M, Morrow SA, Hayward J, Dixon S. The risk of dementia with the use of 5 alpha reductase inhibitors. J Neurol Sci. 2017. doi:10.1016/j.jns.2017.05.064 • PubMed

Pharmacovigilance

Cho Y, Bea S, Bae JH, Kim DH, Lee JH, Shin JY. Cognitive dysfunction following finasteride use: a disproportionality analysis of the global pharmacovigilance database. Expert Opin Drug Saf. 2023. doi:10.1080/14740338.2023.2294926 • PubMed

Fusaroli M, Simonsen A, Borrie SA, et al. Identifying medications underlying communication atypicalities in psychotic and affective disorders: a pharmacovigilance study within the FDA Adverse Event Reporting System. J Speech Lang Hear Res. 2023. doi:10.1044/2023_JSLHR-22-00739PubMed

Review

Kim YJ, Tae BS, Bae JH. Cognitive function and urologic medications for lower urinary tract symptoms. Int Neurourol J. 2020. doi:10.5213/inj.2040082.041 • PubMed

Animal studies

Ahire A, Nair, KP, Shankaranarayana Rao BS, Srikumar BN. The potential involvement of cholinergic system in finasteride induced cognitive dysfunction. Psychoneuroendocrinology. 2021. doi:10.1016/j.psyneuen.2020.105066 • PubMed

Diviccaro S, Giatti S, Borgo F, et al. 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. Psychoneuroendocrinology. 2019. doi:10.1016/j.psyneuen.2018.09.021 • PubMed

Mendell AL, Creighton SD, Wilson HA, et al. Inhibition of 5α reductase impairs cognitive performance, alters dendritic morphology and increases Tau phosphorylation in the hippocampus of male 3xTg-AD mice. Neuroscience. 2020. doi:10.1016/j.neuroscience.2020.01.011 • PubMed

Römer B, Pfeiffer N, Lewicka S, et al. Finasteride treatment inhibits adult hippocampal neurogenesis in male mice. Pharmacopsychiatry. 2010. doi:10.1055/s-0030-1249095 • PubMed

Depression and suicidality

↑ back to top

Clinical trials

Dušková M, Hill M, Hanuš M, Matoušková M, Stárka L. Finasteride treatment and neuroactive steroid formation. Prague Med Rep. 2009. Journal site • PubMed

Rahimi-Ardabili B, Pourandarjani R, Habibollahi P, Mualeki A. Finasteride induced depression: a prospective study. BMC Clin Pharmacol. 2006. doi:10.1186/1472-6904-6-7 • PubMed

Original investigations

Ganzer CA, Jacobs AR. Emotional consequences of finasteride: fool’s gold. Am J Mens Health. 2018. doi:10.1177/1557988316631624 • PubMed

Irwig MS. Depressive symptoms and suicidal thoughts among former users of finasteride with persistent sexual side effects. J Clin Psychiatry. 2012. doi:10.4088/JCP.12m07887PubMed

Melcangi RC, Caruso D, Abbiati F, et al. Neuroactive steroid levels are modified in cerebrospinal fluid and plasma of post-finasteride patients showing persistent sexual side effects and anxious/depressive symptomatology. J Sex Med. 2013. doi:10.1111/jsm.12269 • PubMed

Surendran P, Stewart, ID, Au Yeung VPW, et al. Rare and common genetic determinants of metabolic individuality and their effects on human health. Nat Med. 2022. doi:10.1038/s41591-022-02046-0PubMedPMC full text

Case series

Altomare G, Capella GL. Depression circumstantially related to the administration of finasteride for androgenetic alopecia. J Dermatol. 2002. doi:10.1111/j.1346-8138.2002.tb00200.x • PubMed

Irwig MS. Finasteride and suicide: a postmarketing case series. Dermatology. 2020. doi:10.1159/000505151 • PubMed

Cohort studies

Dyson TE, Cantrell MA, Lund BC. Lack of association between 5α-reductase inhibitors and depression. J Urol. 2020. doi:10.1097/JU.0000000000001079 • PubMed

Garcia-Argibay M, Hiyoshi A, Fall K, Montgomery S. Association of 5α-reductase inhibitors with dementia, depression, and suicide. JAMA Netw Open. 2022. doi:10.1001/jamanetworkopen.2022.48135PubMed

Hagberg KW, Divan HA, Nickel JC, Jick SS. Risk of incident antidepressant-treated depression associated with use of 5α-reductase inhibitors compared with use of α-blockers in men with benign prostatic hyperplasia: a population-based study using the Clinical Practice Research Datalink. Pharmacotherapy. 2017. doi:10.1002/phar.1925 | PubMed

Kim JA, Choi D, Choi S, Chang J, Park SM. The association of 5α-reductase inhibitor with suicidality. Psychosom Med. 2020. doi:10.1097/PSY.0000000000000784 • PubMed

Laanani M, Weill A, Jollant F, Zureik M, Dray-Spira R. Suicidal risk associated with finasteride versus dutasteride among men treated for benign prostatic hyperplasia: nationwide cohort study. Sci Rep. 2023. doi:10.1038/s41598-023-32356-3PubMedPMC full text

Welk B, McArthur E, Ordon M, Anderson KK, Hayward J, Dixon S. Association of suicidality and depression with 5α-reductase inhibitors. JAMA Intern Med. 2017. doi:10.1001/jamainternmed.2017.0089 • PubMedPMC full text

Pharmacovigilance

Ali AK, Heran BS, Etminan M. Persistent sexual dysfunction and suicidal ideation in young men treated with low-dose finasteride: a pharmacovigilance study. Pharmacotherapy. 2015. doi:10.1002/phar.1612 • PubMed

[Abstract] Campbell K, Velazquez O, Sullivan J, Lipshultz L. Finasteride-associated suicide and depression in men treated for hypogonadism and impotence. The Journal of Sexual Medicine. 2022;19(4):S4-S5. doi:10.1016/j.jsxm.2022.01.019

Nguyen DD, Marchese M, Cone EB, et al. Investigation of suicidality and psychological adverse events in patients treated with finasteride. JAMA Dermatol. 2020. doi:10.1001/jamadermatol.2020.3385 • PubMed

Meta-analyses

Deng T, Duan X, He Z, Zhao Z, Zeng G. Association between 5-alpha reductase inhibitor use and the risk of depression: a meta-analysis. Urol J. 2020. doi:10.22037/uj.v16i7.5866 • PubMed

Kim JH, Shim SR, Khandwala Y, Del Giudice F, Sorensen S, Chung BI. Risk of depression after 5 alpha reductase inhibitor medication: meta-analysis. World J Mens Health. 2020. doi:10.5534/wjmh.190046 • PubMed

Pompili M, Magistri C, Maddalena S, Mellini C, Persechino S, Baldessarini RJ. Risk of depression associated with finasteride treatment. J Clin Psychopharmacol. 2021. doi:10.1097/JCP.0000000000001379 • PubMed

These findings were updated in Baldessarini et al, 2021, found in ‘Research letters.’

Research letters

Baldessarini RJ, Pompili M. Further studies of effects of finasteride on mood and suicidal risk. J Clin Psychopharmacol. 2021. doi:10.1097/jcp.0000000000001485 • PubMed

This letter is an update to Pompili et al, 2021, found in ‘Meta-analyses.’

Brezis M. Neuropsychiatric reactions to finasteride: nocebo or true effect? J Basic Clin Pharma. 2023;14(1):220-222. Web • PDF

Römer B, Gass P. Finasteride-induced depression: new insights into possible pathomechanisms. J Cosmet Dermatol. 2010. doi:10.1111/j.1473-2165.2010.00533.x • PubMedErratum in: J Cosmet Dermatol. 2011.

Reviews

Al Saffar H, Xu J, O’Brien JS, Kelly BD, Murphy DG, Lawrentschuk N. US Food and Drug Administration warning regarding finasteride and suicidal ideation: What should urologists know? Eur Urol Open Sci. 2023. doi:10.1016/j.euros.2023.04.009 • PubMed • PMC full text

Bortnick EM, Simma-Chiang V, Kaplan SA. Long-term consequences of medical therapy for benign prostatic hyperplasia. Rev Urol. 2019. PubMed • PMC full text

Gur S, Kadowitz PJ, Hellstrom WJ. Effects of 5-alpha reductase inhibitors on erectile function, sexual desire and ejaculation. Expert Opin Drug Saf. 2013. doi:10.1517/14740338.2013.742885

Müderrisoglu AE, Becher KF, Madersbacher S, Michel MC. Cognitive and mood side effects of lower urinary tract medication. Expert Opin Drug Saf. 2019. doi:10.1080/14740338.2019.1652269 • PubMed

Saengmearnuparp T, Lojanapiwat B, Chattipakorn N, Chattipakorn S. The connection of 5-alpha reductase inhibitors to the development of depression. Biomed Pharmacother. 2021. doi:10.1016/j.biopha.2021.112100 • PubMed • Full text

Singh MK, Avram M. Persistent sexual dysfunction and depression in finasteride users for male pattern hair loss: a serious concern or red herring? J Clin Aesthet Dermatol. 2014. PubMed

Traish AM, Hassani J, Guay AT, Zitzmann M, Hansen ML. Adverse side effects of 5α-reductase inhibitors therapy: persistent diminished libido and erectile dysfunction and depression in a subset of patients. J Sex Med. 2011. doi:10.1111/j.1743-6109.2010.02157.x • PubMed

Traish AM, Mulgaonkar A, Giordano N. The dark side of 5α-reductase inhibitors’ therapy: sexual dysfunction, high Gleason grade prostate cancer and depression. Korean J Urol. 2014. doi:10.4111/kju.2014.55.6.367 • PubMed

Walton NL, Antonoudiou P, Maguire JL. Neurosteroid influence on affective tone. Neurosci Biobehav Rev. 2023. doi:10.1016/j.neubiorev.2023.105327 • PubMed

Editorials & commentaries

Schmutz JL. Dépression et idées suicidaires avec le finastéride [Depression and suicidal thoughts associated with finasteride]. Ann Dermatol Venereol. 2018. doi:10.1016/j.annder.2018.01.006 • PubMed

Thielke S. The risk of suicidality and depression from 5-α reductase inhibitors. JAMA Intern Med. 2017. doi:10.1001/jamainternmed.2017.0096 • PubMed

Trüeb RM, Gavazzoni Dias MFR, Dutra Rezende H. Suicidality and psychological adverse events in patients treated with finasteride. Skin Appendage Disord. 2021. doi:10.1159/000514365 • PubMed • PMC full text

Animal studies

Diviccaro S, Giatti S, Borgo F, et al. 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. Psychoneuroendocrinology. 2019. doi:10.1016/j.psyneuen.2018.09.021 • PubMed

Maurice-Gélinas C, Deslauriers J, Monpays C, Sarret P, Grignon S. The 5α-reductase inhibitor finasteride increases suicide-related aggressive behaviors and blocks clozapine-induced beneficial effects in an animal model of schizophrenia. Physiol Behav. 2018. doi:10.1016/j.physbeh.2018.03.036 • PubMed

Sasibhushana RB, Shankaranarayana Rao BS, Srikumar BN. Repeated finasteride administration induces depression-like behavior in adult male rats. Behav Brain Res. 2019. doi:10.1016/j.bbr.2019.03.006 • PubMed

Other psychiatric conditions

↑ back to top

Harth W, Linse R. Body dysmorphic disorder and life-style drugs. Overview and case report with finasteride. Int J Clin Pharmacol Ther. 2001. doi:10.5414/cpp39284 • PubMed

Trüeb RM. Psychiatric comorbidity related to the therapy of male androgenetic alopecia independent of the 5-alpha reductase pathway. Skin Appendage Disord. 2022. doi:10.1159/000518750 • PubMed • PMC full text

Trüeb RM, Régnier A, Dutra Rezende H, Gavazzoni Dias MFR. Post-finasteride syndrome: an induced delusional disorder with the potential of a mass psychogenic illness? Skin Appendage Disord. 2019. doi:10.1159/000497362 • PubMed