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The following is a summary of “Risk of psychiatric disorders in finasteride users with benign prostatic hyperplasia and androgenetic alopecia: A population-based case–control study,” published in the August 2024 issue of Dermatology by Lyakhovitsky et al.

The debate continues over whether finasteride, a drug used for benign prostatic hyperplasia (BPH) and androgenetic alopecia (AGA), can cause mental health issues.

Researchers conducted a retrospective study assessing the relationship between finasteride therapy for BPH and AGA and the development of mental health conditions.

They compared data from patients with BPH taking finasteride 5 mg daily and patients with AGA  taking finasteride 1 mg daily with age- and gender-matched controls. Psychological outcomes, including depression, anxiety, neuroses, bipolar disorder, schizophrenia, psychoses, and alcohol abuse, were evaluated within 2 years of starting finasteride therapy and compared outcomes between the finasteride groups and controls.

The results showed the BPH group, comprising 307 men aged 61.5 (±17.4) years and 1,218 controls, had mental health issues in 2.3% of patients with no significant difference from controls. The AGA group, consisting of 23,227 men aged 31.4 (±10.3) years and 39,444 controls, had a 1% rate of psychiatric disorders. Patients with AGA had higher rates of anxiety (0.6% vs. 0.4%, P=0.04) and depression (0.5% vs. 0.4%, P=0.007) compared to controls. Multivariate regression revealed that finasteride was a risk factor for anxiety (OR 1.449, P=0.002) and depression (OR 1.439, P=0.003) after adjusting for age, sector, socioeconomic status, and comorbidities.

Investigators concluded that finasteride therapy did not significantly increase the risk of mental health conditions in patients with BPH but was associated with a slight increase in anxiety and depression in patients with AGA.

Source: onlinelibrary.wiley.com/doi/abs/10.1111/ajd.14359