76976 Association of Depression with Finasteride Stratified by Dosage and Diagnosis: A Retrospective Cohort Study Using the TriNetX Database

This retrospective cohort study using the TriNetX database examined the association between finasteride use and psychiatric adverse effects in men with androgenic alopecia (AGA) and benign prostatic hyperplasia (BPH). The study included three cohorts: men with AGA on 1 mg finasteride, men with BPH on 5 mg finasteride, and controls without finasteride, AGA, or BPH. Results showed that AGA patients on 1 mg finasteride had a decreased risk of depression, suicidal ideation, and suicide attempts, while BPH patients on 5 mg finasteride had increased risks for these outcomes. These findings suggest that psychiatric risks associated with finasteride are context-dependent, potentially protective in younger AGA patients but elevated in older BPH patients, highlighting the need for careful psychiatric monitoring and patient counseling, especially at higher doses.