Propecia, Depression & Suicide

Could a pill meant to restore your confidence actually be putting your mental health at risk? Finasteride, commonly known as Propecia, is widely used to combat androgenetic alopecia or male pattern baldness. While it promises to halt hair loss, emerging evidence suggests it might come with severe psychological consequences that are too significant to ignore.

UK and French Regulatory Warnings

The UK Medicines and Healthcare products Regulatory Agency (MHRA) issued warnings about the risk of persistent psychiatric and sexual side effects from finasteride. They have introduced a patient alert card to raise awareness among users and prescribers. The MHRA highlighted that “finasteride has been associated with depression, suicidal thoughts and sexual dysfunction” and that “patients have reported that sexual dysfunction…has persisted even after treatment was stopped” [3][4].

France is also taking these concerns seriously. On October 26, 2023, the French National Agency for Drug Safety (ANSM) issued a warning stating that “Changes in mood, particularly depression, and suicidal ideation, have been reported by patients taking Propecia.” They advised discontinuing finasteride in the presence of any psychiatric symptoms and noted the possibility of persistent sexual disorders even after stopping treatment. Dr. Caroline Semaille, ANSM’s director of dermatology, launched a public-awareness campaign to highlight these potential dangers, emphasizing that patients should be fully informed of the risks [6].

Controversy Surrounding Merck

Adding to the controversy, Merck, the manufacturer of finasteride, has faced accusations of not being fully transparent about the drug’s risks. Reports have surfaced suggesting that Merck knew about the potential severe side effects but failed to adequately disclose them. According to Reuters, “Thousands of men who took Propecia…have reported experiencing persistent sexual dysfunction and suicidal thoughts, which they allege were not properly disclosed by Merck” [5].

Moving Forward: Balancing Risks and Benefits

These developments raise a crucial question: are we overlooking the potential dangers of finasteride in our quest for a full head of hair? The FDA now advises doctors to screen for mental health issues before prescribing finasteride and to monitor patients closely for any new mental health symptoms. They recommend that healthcare professionals “advise patients to stop finasteride immediately if they develop depression or suicidal thoughts and to contact their doctor as soon as possible” [2].

Conclusion

The implications of this study are clear: more research is needed to fully understand why these psychological effects occur and how to prevent them. However, in the meantime, awareness and careful monitoring are crucial. The desire for a full head of hair should not come at the expense of mental health. Balancing physical appearance with psychological well-being is key, and this can be achieved through informed decision-making and ongoing conversations between patients and healthcare providers.

Sources

• Haidar Al Saffar, Jennifer Xu, Jonathan S. O’Brien, Brian D. Kelly, Declan G. Murphy, Nathan Lawrentschuk. US Food and Drug Administration Warning Regarding Finasteride and Suicidal Ideation: What Should Urologists Know?
• FDA Adds Suicidal Thoughts to Finasteride Side Effects
• Finasteride: review of safety data and expert advice on management of risks – GOV.UK
• Finasteride: reminder of the risk psychiatric side effects and of sexual side effects (which may persist after discontinuation of treatment) – GOV.UK
• Merck’s Lack of Transparency About Finasteride Risks
• PFS Foundation: ANSM Warning of Propecia-Induced Depression and Suicidal Ideation Prompts Media Attention