US Food and Drug Administration Warning Regarding Finasteride and Suicidal Ideation: What Should Urologists Know?

The US FDA has added suicidal ideation (SI) to the list of adverse effects for finasteride, a drug used to treat benign prostatic hyperplasia (BPH) and androgenic alopecia (AGA). Despite patient reports and advocacy group petitions, a clear causal link between finasteride and SI remains unproven due to a lack of comprehensive randomized studies. Evidence from dermatology suggests higher rates of depressive symptoms among 5-ARI users. Urologists should screen for mental health issues before prescribing finasteride and monitor patients for new-onset depression or SI. Further research is needed to establish a definitive connection between finasteride and SI.