Finasteride and suicidal thoughts: the warnings
Worried about your mood on finasteride (Propecia), or since stopping it? What the leaflet tells you to do, what regulators changed, and where to get help.
Low mood or dark thoughts since you started finasteride (Propecia)? Regulators in the UK, France and the US warn that finasteride has been linked to depression and suicidal thoughts.
Some people say these problems can last after stopping, as part of post-finasteride syndrome (PFS).
If you’re struggling right now, the Samaritans are free to call on 116 123, day or night. You don’t have to explain anything about finasteride to talk to them.
Sam took finasteride for his hair after his GP suggested it. In this interview he describes the only warning he remembers getting, and what came after. Watch it to hear, in his own words, how little he was told.
Was anything said about problems lasting? “Nothing permanent,” he says.
What exactly do the warnings say, and what can you do if your mood drops?
What does the Propecia leaflet say about mood?
The UK leaflet for the 1 mg tablet is direct. It says “depressed mood, depression and, less frequently, suicidal thoughts have been reported”. If that happens, it tells you to “stop taking Propecia and contact your doctor”.
It adds that sexual problems “may contribute to mood alterations, including suicidal thoughts”. It also says sexual problems have been reported without any change in mood.
The same leaflet lists “persistent difficulty having an erection after discontinuation of treatment”, and lasting problems with sex drive and ejaculation. A patient card comes in the pack. Our page on the finasteride warnings shows what the card says.
PFS isn’t only about sex. Proposed diagnostic criteria from 2022 say cognitive problems, depression and suicidal thoughts “can occur independently of any sexual difficulties”.
What did the UK regulator do?
In April 2024 the MHRA, the UK medicines regulator, reminded prescribers that “finasteride has been associated with depression, suicidal thoughts and sexual dysfunction”.
It asked doctors to check for a history of depression or suicidal thoughts before prescribing. It also said “in some cases sexual dysfunction has persisted in patients even after they have stopped taking finasteride”.
Up to April 2024, the MHRA had received 281 Yellow Card reports linking finasteride to low mood or suicidal and self-harming behaviour. These are reports, not proof that the tablet caused each one. Reporting is voluntary, so the real number is unknown.
The MHRA’s full review sets out the expert advice behind the alert card.
What did France and the US say?
France warned years before the UK. The French medicines agency, the ANSM, issued its warning in October 2017. It said “changes in mood, particularly depression, and suicidal ideation, have been reported by patients taking Propecia”, according to the PFS Foundation’s report. It said treatment should stop if any psychiatric symptoms appear, and that sexual problems could persist after stopping.
In the US, the FDA added suicidal ideation to finasteride’s list of side effects after patients reported it. A 2023 paper for urologists says a causal link with suicidal thoughts is still unclear, because large randomised studies are missing. Its authors advise doctors to screen for mental health risk and arrange follow-up.
Regulators act on reports and smaller studies. Nobody has measured how often this happens.
Merck, the company behind Propecia, has faced lawsuits in the US from men and families who say the risks weren’t made clear. Merck denies the claims.
In 2019 Reuters reported on Propecia court records that were kept sealed. One of the people in that report is Kelly Pfaff, whose husband John died by suicide. She believes finasteride played a part. Our summary of the Reuters investigation covers the story.
What can you do?
Finasteride helps many people with hair loss. Whether to keep taking it is a decision for you and your prescriber. If your mood drops, don’t wait: the leaflet says to contact your doctor.
Questions for your GP
- Could my low mood be linked to finasteride, even after stopping?
- What support can I get for my mood now?
- What's our next step if it doesn't ease?
You could start with: "My mood changed after I started finasteride, and the leaflet warns about this."
Write down the dose and dates, for example “Finasteride 1 mg from March 2022, last tablet June 2023.” Note when your mood changed, and anything else that changed.
Report it: it helps everyone
A doctor’s note helps you. A report to the medicines regulator helps everyone else: it is how patterns get noticed.
- No proof needed. A suspicion is enough, even years after stopping.
- Where: the Yellow Card scheme in the UK, MedWatch in the US.
- Use the right words. If symptoms continued after stopping, write Post 5-alpha-reductase inhibitor syndrome (MedDRA 10082430).
Our reporting guide walks you through it
What else do people ask?
Can depression from finasteride start after stopping? Some people with PFS describe mood problems that began or got worse after their last tablet. The 2022 criteria include depression as part of PFS. Nobody has measured how often this happens. Tell your doctor when it started, either way.
Does it affect only men taking 1 mg? The MHRA warning covers both finasteride 1 mg for hair loss and 5 mg for an enlarged prostate. For 5 mg, it says to tell your doctor as soon as possible if you have depression or suicidal thoughts.
Is PFS just depression? No. The 2022 criteria describe lasting sexual changes, cognitive problems, depression and suicidal thoughts, which can occur on their own. Our page on PFS or depression covers how the two differ.
If you’re finding things hard, you don’t have to wait for answers to get help. Call the Samaritans on 116 123, and read more on our PFS page.
Sources
- Organon Pharma (UK). Propecia 1 mg patient information leaflet, electronic Medicines Compendium, last revised May 2026. Section 2: “Mood alterations such as depressed mood, depression and, less frequently, suicidal thoughts have been reported”. Also “stop taking Propecia and contact your doctor”. Also “Impaired sexual function that may contribute to mood alterations, including suicidal thoughts, has been reported”. And “Impaired sexual function has also been reported without mood alterations or suicidal thoughts”. Section 4: “persistent difficulty having an erection after discontinuation of treatment”.
- MHRA. Finasteride: reminder of the risk of psychiatric side effects and of sexual side effects (which may persist after discontinuation of treatment), Drug Safety Update, 29 April 2024. 281 reports of depressed mood disorders and suicidal and self-injurious behaviours up to 5 April 2024. UK.
- MHRA. Finasteride: review of safety data and expert advice on management of risks. UK. Not re-opened on 22 October 2026.
- PFS Foundation. ANSM warning of Propecia-induced depression and suicidal ideation prompts media attention, 19 December 2017. Reports the ANSM (France) warning of 26 October 2017. Secondary source; the ANSM original was not opened.
- Al Saffar H, Xu J, O’Brien JS and colleagues. US Food and Drug Administration warning regarding finasteride and suicidal ideation: what should urologists know? Eur Urol Open Sci 2023;52:4-6. Commentary; says the causal link remains unclear without large randomised studies. US.
- Healy D, Bahrick A, Bak M and colleagues. Diagnostic criteria for enduring sexual dysfunction after treatment with antidepressants, finasteride and isotretinoin. Int J Risk Saf Med 2022;33(1):65-76. Proposed criteria from expert agreement. Section 5: cognitive impairment, depression and suicidality “can occur independently of any sexual difficulties”.
- Reuters. Court let Merck hide secrets about a popular drug’s risks, 2019. US. Could not be opened on 22 October 2026.
- Moral Medicine. The Hidden Devastation of Finasteride: Sam’s Story, June 2025.
- GOV.UK. Report a problem with a medicine or medical device.
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