Finasteride-Induced Neuropsychiatric Reactions

Finasteride, commonly used for androgenetic alopecia, has been linked to persistent neuropsychiatric adverse effects such as depression, anxiety, cognitive impairment, and suicidality. Evidence from various studies supports a causal relationship, highlighting issues like reduced neurosteroid synthesis affecting mood and neurogenesis. Regulatory bodies have updated safety warnings, and some countries now require informed consent before prescription. Despite its short-term efficacy for hair loss, the long-term benefits are unclear, and there's a significant increase in depression risk. Given alopecia's cosmetic nature and alternative treatments, the precautionary principle suggests avoiding finasteride, emphasizing the need for comprehensive risk disclosure and shared decision-making in clinical practice.