Failing Public Health Again? Analytical Review of Depression and Suicidality From Finasteride
Mayer Brezis
The Journal of Clinical Psychiatry · 86(4):25nr158622025-09-22
Summary (paraphrased)
A narrative review by Mayer Brezis (Braun School of Public Health, Hadassah-Hebrew University) arguing that finasteride can cause depression, anxiety and suicidality, including after it is stopped, and analysing why recognition took two decades. Concerns appeared in studies from 2002; between 2017 and 2023, four analyses of adverse event reporting systems and four studies mining health records found a raised risk. Comparing the suicides reported to the FDA's adverse event system by 2024 (320) with the number he calculates would be expected over 30 years of use (19,320), the author argues for gross underreporting, and by an extrapolation he calls speculative estimates that over 20 years hundreds of thousands of users may have had depression and hundreds to thousands may have died by suicide. He attributes the delay to the manufacturer not running or publishing simple database pharmacovigilance studies and to regulators not requiring them, invokes the precautionary principle for a drug with a cosmetic indication, and concludes that regulators should require, and enforce, ongoing post-approval analytical studies.
Why it’s in the corpus
A single argument that pulls the finasteride depression and suicidality signals together and makes the case that regulators were slow; eight of its references are already in the library (among them DISC-013, LIT-049, LIT-010 and PFS-003). It is an analytical narrative review, not new data, and its harm estimates are the author's own extrapolations. Read alongside the FDA's 2022 response to the PFS Foundation petition (LIT-072) and the EMA's 2025 finasteride review (LIT-065).
Related records
- Peer-reviewed paper
Post-finasteride syndrome: a surmountable challenge for clinicians
Traish, Abdulmaged M. · Fertility and Sterility · 113(1):21-50
Systematic evaluation of 250+ articles (1989–2019) on finasteride/dutasteride concludes PFS is a real constellation of persistent sexual, neurological, physical and mental effects in a susceptible subset, proposing endocrine disruption plus epigenetic…
PFS-0012020PFSCore corpus - Peer-reviewed paper
The connection of 5-alpha reductase inhibitors to the development of depression
Thiraphat Saengmearnuparp; Bannakij Lojanapiwat; Nipon Chattipakorn; Siriporn Chattipakorn · Biomedicine & Pharmacotherapy
Clinical studies indicate that former users of 5-alpha-reductase inhibitors carry a higher incidence of depressive symptoms and neuropsychiatric side effects than non-users, yet the mechanisms behind depression in former users — sometimes called…
ARLIT-0512021PFSLiterature sweep · Oct 2026 - Peer-reviewed paper
Enduring sexual dysfunction after treatment with antidepressants, 5α-reductase inhibitors and isotretinoin: 300 cases
Healy, David; Le Noury, Joanna; Mangin, Dee · International Journal of Risk & Safety in Medicine · 29(3-4):125-134
Drawing on reports submitted to the RxISK.org adverse-event site, the authors assembled 300 cases of persistent sexual difficulty from 37 countries after treatment with serotonin reuptake inhibiting antidepressants, finasteride-type drugs, or isotretinoin…
CROSS-0012018PFSPSSDPRSDCore corpus