Finasteride (and the related drug dutasteride) carries a small but real risk of mood and sexual side effects that can occasionally persist even after stopping -- men considering these drugs for hair loss should be told about this risk upfront, not just reassured it is rare.
What they did
The UK Medicines and Healthcare products Regulatory Agency (MHRA) reviewed spontaneous adverse-event reports and published literature on finasteride's psychiatric and sexual side effects, prompted by patient advocacy and a rise in reported cases.
What they found
Mood changes (depressed mood, depression, and, less often, suicidal thoughts) were reported, more frequently early in treatment. Sexual dysfunction (reduced libido, erectile difficulty) is the most frequent adverse effect, typically appearing early and resolving with continued treatment in most but not all patients; in some cases sexual dysfunction persisted after stopping the drug. The MHRA strengthened product warnings and introduced a patient alert card.
Limitations
Based largely on spontaneous adverse-event reporting, which is prone to reporting bias and cannot prove the drug caused the effects; this is a regulatory bulletin, not a controlled trial. Full text could not be accessed directly (blocked); relied on search-engine summaries and corroborating Medscape/Pharmaceutical Journal coverage of the same MHRA review.
Who paid for it
Not applicable -- regulatory body publication
Read the original
Safety update: psychiatric and sexual adverse effects with finasteride ↗ · Drug and Therapeutics Bulletin editorial panel (MHRA safety review) · we summarised this from the abstract
Discussion
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