Dihydrotestosterone and Finasteride Effects on Alcohol Cue-Elicited Brain Activity in Males With Heavy Episodic Drinking

This study examined the effects of finasteride, a 5α-reductase inhibitor, on brain activity in response to alcohol cues in 50 males with heavy episodic drinking. Using a randomized, placebo-controlled, double-blind, crossover design, the study found that finasteride reduced dihydrotestosterone levels without affecting testosterone or allopregnanolone concentrations. While dihydrotestosterone was not significantly associated with brain activation or alcohol craving, finasteride was linked to increased brain activity in regions related to reward processing and behavioral control, and it increased the desire to abstain from alcohol. These findings suggest finasteride's potential as a neuromodulatory agent in reducing alcohol-related brain activity and craving, highlighting its possible therapeutic role in treating alcohol use disorder. However, the study's small sample size and lack of correction for multiple hypothesis testing suggest that further research is needed.