5α-Reductase Isoenzymes: From Neurosteroid Biosynthesis to Neuropsychiatric Outcomes
Rodríguez-Cerdeira, Carmen; Freus, Marika; Misiakiewicz-Has, Kamila; Pilutin, Anna; Kolasa, Agnieszka; Maksym, Radoslaw; Kajdy, Anna
NeuroSci (systematic review; PRISMA 2020)2025
Abstract (paraphrased)
PRISMA systematic review (PubMed/Scopus/Web of Science to Feb 2025; 83 included articles) on SRD5A1/2/3 tissue distribution: SRD5A1 drives CNS allopregnanolone synthesis; impaired neurosteroidogenesis from 5α-reductase inhibition is linked to anxiety, depression and suicidality vulnerability; calls for genetics-plus-biomarker studies to identify at-risk individuals.
Plain-language summary (paraphrased)
A sweeping review of how the three 5-alpha-reductase enzymes work across the body and brain. It concludes that blocking these enzymes impairs the brain's production of calming neurosteroids, which can explain the anxiety, depression and suicidal thoughts reported with finasteride — and it explicitly calls for genetic studies to predict who is vulnerable.
Why it’s in the corpus
Most current synthesis of 5α-reductase biology; directly ties the drug target's genetics (SRD5A genes) to neuropsychiatric risk — central to the pharmacology/genetics focus.
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