A new study, published in JAMA Dermatology, examines associations between suicidality and other negative psychological side effects and finasteride, a commonly used hair loss drug. The researchers found that finasteride may be linked to suicidality and adverse psychological events in men younger than 45 years-old prescribed the drug to treat hair loss.
The researchers urge clinicians to be cautious when prescribing this medication and to be aware of any potential negative psychological side effects shown by their patients. They also highlight the need for further research to be conducted to gain a clearer understanding of the relationship between finasteride and mental health issues. The researchers, led by Dr. Quoc-Dien Trinh, of the Division of Urologic Surgery at Brigham and Women’s Hospital, write:
“Increasing concerns over fatal outcomes linked to finasteride use have caught the attention of media and regulators alike. In light of this and the limited literature on this association, we sought to investigate psychological adverse events and suicidality associated with post-finasteride syndrome.”
Finasteride has received attention from the media and health authorities in the U.S., Canada, Korea, New Zealand, and the United Kingdom for its reported links to depression, self-harm, and suicide. Concerns about the drug and its negative side effects have resulted in the development of organizations like the Post-Finasteride Syndrome Foundation and terms like “postfinasteride syndrome.” Yet, despite widespread concern, studies investigating connections between suicidality and finasteride are limited.
In the current study, researchers explored potential correlations between finasteride use and suicidality, which they define as including suicidal thinking, attempts, and completed suicide, as well as psychological adverse events, which they define as depression and anxiety.
The researchers used data from VigiBase, an international database run by the World Health Organization. The database spans 153 countries and includes drug-adverse reaction pairs. The researchers used statistical analyses to investigate potential associations between suicidality, adverse psychological events, and the use of finasteride and other similar hair loss medications.
A total of over 3,000 cases of suicidality (356) and/or psychological adverse events (2,926) were identified as being associated with finasteride use. The individuals affected were predominantly men (98.9%), ages 18-44 (70.9%), and most resided in the Americas (63.5%) or Europe (32.6%).
Regarding their findings, the researchers write:
“Taken together, our findings suggest that the disproportional reporting of suicidality and psychological adverse events in association with finasteride use could potentially be attributed to unique characteristics of the drug in young patients with alopecia.”
They highlight that the negative psychological side effects associated with finasteride use in younger men could be the result of persistent sexual dysfunction shown to be correlated with the drug. Researchers support this hypothesis by pointing to the case of 6 men who completed suicide who had been taking finasteride for hair loss and who had experienced persistent sexual dysfunction even after stopping finasteride use.
Prolonged sexual dysfunction associated with finasteride use has been long documented. A citizen petition in 2018 called for more thorough informed consent practices wherein prescribers clearly explain the risks associated with the drug to prospective users.
Researchers also examined suicidality and psychological adverse events in similar drugs used to treat hair loss, such as dutasteride, minoxidil, and tamsulosin. They did not find the same associations as they did with finasteride. They explore why only finasteride, and not similar drugs, might be implicated in suicidality and mental health issues.
The researchers suggest that perhaps the media attention associated with finasteride might lead to reporting bias or a tendency to focus more on finasteride and its adverse effects as opposed to other hair loss drugs. They point to a finding in their analysis which indicates disproportional reporting of suicidality connected to finasteride use after 2012, which, perhaps not so coincidentally, was the same year that studies highly publicized negative effects of finasteride and the year the Post-Finasteride Syndrome Foundation was founded.
The study’s limitations include the likely underreporting of adverse events, given the scope and span of the international database. Researchers also did not examine external contributors to or protective factors of depression and suicidality, like social support and socioeconomic status. Therefore, they cannot draw definite conclusions that finasteride was the sole contributor to adverse psychological effects.
Additionally, self-reliance, a dominant characteristic of masculinity, and economic policy uncertainty have been shown to contribute to suicidal thinking and suicide in men, indicating other risk factors to address in further explorations of finasteride’s side effects.
In light of the study’s limitations, the researchers conclude with a call for caution when prescribing and for further research to more deeply investigate potential associations between finasteride, suicidality, and adverse psychological events.
Nguyen, D-D., Marchese, M., Cone, E. B., Paciotti, M., Basaria, S., Bhojani, N., & Trihn, Q-D. (2020). Investigation of suicidality and psychological adverse events in patients treated with finasteride. JAMA Dermatology. doi:10.1001/jamadermatol.2020.3385 (Link)
Well perhaps they can market it under a new name and sell it as an “anti-depressant”. The effects seem very similar. Oopsy. Perhaps bald doctors are the ones using this product, although I somehow doubt it.
Oh, they’ll probably “reformulate” it and maybe like Sam Plover said, “remarket” as an “anti-depressant” or maybe even “anti-psychotic”. Then, they’ll have ads on tv showing how wonderful life could be for those who are prescribed this drug. Then, within a year or so, it will come out there are some harmful effects of this drug and the predatory lawyers will advertise on tv for their services due to the harm that may have been done to you or a loved one. But, we only collect, if you win and this is a “time-limited offer.” How cynical I can be, sometimes. Thank you.
If they do market it as an “anti-depressant”, people will still feel suicidal, like they do with psych drugs, but at least they can be comforted with a full head of hear.
Hey, losing hair is definitely a social stressor. Could “uncover” an “underlying depressive disorder” when you go bald!
In a bold move bald man Steve McCrea suggests baldness as a biomarker for depression. While research hasn’t been conducted yet, top psychiatric experts agree this could be a breakthrough in finding the biological causes of depression. They assume there is a chemical imbalance at the root of hair and depression.
I call that getting to the ROOT of the problem!
And I’m not ENTIRELY bald yet. So I must have a mild case!
Steve McCrea and beokay have made my day! Please tell those crazy shrinks I never had depression or any related disorders; as I have always had lots of hair. In fact, I was born with so much hair the nuns put a bow in my hair when they brought me a mere just-born infant to my mother. And, even, now. despite all the evil drugs, I still don’t need the Women’s Hair Clubs or other crazy hair making treatments. How many more people will this free from psychiatric tyranny! Thank you.
It sounds like you may have been misdiagnosed! Or at least you’re in remission!
Sorry Steve, should have taken a closer look at your pic, begore diagnosing xou with baldness. xD
Too much hair obviously causes mania.
Though it is true that as I lost hair, I became less and less depressed over the years. So I think the correlation is very real!
LOL!! you two.
Speaking of “misdiagnosed”, is there such a thing in psych? I mean do they ever write that down and erase all evidence of the “wrong” diagnosis?
There are so many false positives in medicine, I mean even with the kinda rudimentary science, so it is AMAZING that psych just can’t get it wrong. Like each and every disorder is lifelong, and each one is bang on and if it’s not, well they just add overlaps and shit like that.
I guess one can be bang on if the tests don’t change lol.
You would not believe the trouble of trying to get a haircut in downtown Louisville. I didn’t grow bald but the language used when I would request a cease and desist, woud just keep coming. Perhaps one might experience a blood letting again? There are certain rules that go along with the Barbers and then there were the rules that were broken in the recent social protests. Too much broken glass and hardening of attitudes in search of the how and why for a more peaceful city.