Finasteride and depression: is there a relationship?

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Hair loss can become a pressing problem for some people and in some cases a real obsession.

The androgenetic alopecia is the most common cause of hair loss and numerous studies have shown that about 50% of people over 50 years suffer from it in a more or less severe form.

Among the many over-the-counter and prescription drugs for the treatment of baldness, there is one in particular that has generated controversy for some recent investigations that link its use to an increase in depressive behavior and in some cases even to the development of suicidal tendencies.

Worrying discoveries: the investigation of Reuters

The drug in question is finasteride, sold under the trade name of Propecia.

An investigation by the Reuters news agency that analyzed declassified court documents and records shows that both U.S. regulators and the drug’s manufacturer (Merck, Sharp&Dohme) were aware of reports of suicidal behavior by users of Propecia.

Both the manufacturer and regulators, during the 2011 review of Propecia’s package insert, failed to update it to include more information about this new potential risk.

Reuters in its investigation revealed how the Food and Drug Administration (FDA) since 2011 has received more than 700 reports of suicidal tendencies or deaths among users of Propecia or generic versions of finasteride.

The number of deaths by suicide among users of finasteride was at least 100 people.

Reuters also reports that during the first 14 years of Propecia’s sale, the FDA had received only 34 reports, 10 of which referred to deaths by suicide.

The news agency revealed that an internal search by Merck itself in 2009 had revealed the existence of more than 200 reports to the manufacturer mentioning problems of depression and suicidal thoughts among men taking Propecia.

At the time, it was determined that the number of reports regarding supposed depressive or suicidal behavior was not such that anything more than normal monitoring of the situation was required.

The study published in the Journal of American Medical Association

A study published in 2020 by the prestigious Journal of American Medical Association showed that reports of anxiety problems, depression and suicidal tendencies among men younger than 45 who were using finasteride increased significantly from the year 2012.

For this research we relied on the database of drug safety reports collected in over 150 countries by the World Health Organization.

It should be noted that, also in 2012, the Italian Medicines Agency (Aifa) reported data from a study that showed depressive symptoms and suicidal tendencies in patients treated with finasteride.

Finasteride and depression: Merck’s response

Merck’s official response was that: “the scientific evidence is insufficient to believe that there is a causal link between the use of Propecia and the development of suicidal tendencies and consequently these terms should not be used in the package insert”.

The manufacturer’s statement went on to indicate how “Merck will continue to work closely with regulators to ensure that potential issues related to the use of the drug is analyzed in detail and if necessary, reported in the Propecia package insert.”

The FDA in turn issued a statement saying that it will continue to monitor Propecia’s post-marketing safety data.

The FDA also emphasized that the fact that these reports exist does not mean that “the drug caused the adverse event” and that these problems (depression, suicidal tendencies) may be due to “underlying conditions for which the patient was being treated, or to concomitant intake of other medications, or to other reasons.”

Our personal advice is to always check your state of mind while taking Finasteride and to look for possible alternatives if you have suffered from depression or other mental disorders in the past.

In case the hair loss way is causing depression a good support tool could be to share your feelings anonymously with other people who suffer from the same problem, through specialized forums such as Bellicapelliforum.

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