Signal Detection of Depression and Suicidality Associated with Finasteride and Dutasteride: Updated Pharmacovigilance Evidence and Recommendations for Comprehensive Psychiatric Assessment

The study examines the link between finasteride and dutasteride, both 5α-reductase inhibitors, and neuropsychiatric adverse reactions using the FAERS database. It finds that finasteride is more frequently associated with depression, anxiety, suicidality, and libido-related issues, particularly in younger men using it for alopecia. Potential mechanisms include reduced neurosteroid synthesis and hormonal disruptions. The study stresses the importance of baseline psychiatric assessments and regular monitoring of mood and sexual function for users of these drugs. Limitations include under-reporting and lack of incidence data, necessitating further controlled studies to better understand these associations.