Response to: “finasteride prescribed for hair loss consistently leads to depression”

The response to the claim that "finasteride prescribed for hair loss consistently leads to depression" emphasizes the importance of considering the totality of evidence rather than relying on selective, lower-quality data. The authors argue that the literature on finasteride and depression is varied, and many studies suffer from methodological limitations such as reporting biases and confounding factors. They highlight that disproportionality analyses, often used to suggest a link between finasteride and depression, cannot establish causation. In contrast, large-scale studies, including Mendelian randomization involving over 2.7 million subjects, found no causal association between finasteride use and depression. Additionally, the authors note that the observed signals of depression do not align with expected pharmacological effects, such as dose-response relationships. They conclude that current evidence does not support the broad claim that finasteride consistently leads to depression, and caution against messaging that could amplify nocebo effects.