Finasteride: A Cosmetic Drug with Serious Mental Health Risks

For over two decades, finasteride has been prescribed to millions of men seeking to slow down or reverse hair loss. Despite its cosmetic appeal, increasing evidence suggests serious mental health consequences, including depression, anxiety, and in some cases, suicide.

Growing Evidence of Psychological Harm

Finasteride is one of the well-known drugs for treating male pattern baldness and was approved by the U.S. Food and Drug Administration (FDA) in 1997. However, recent studies indicate that users may experience mood disorders and suicidal thoughts more frequently than non-users. This pattern has become evident in various national databases, such as the FDA’s Adverse Event Reporting System and healthcare records in Sweden, Canada, and Israel.

Professor Mayer Brezis from the Hebrew University of Jerusalem asserts that the medical community and regulators have failed to protect the public by ignoring the signs of the drug’s psychological harm.

Psychological Damage and Its Wide Impact

Reports estimate that hundreds of thousands of users have suffered from finasteride-related depression, and hundreds more may have died by suicide. Although the FDA acknowledged depression as a potential side effect in 2011 and added suicidal thoughts to the label in 2022, researchers have been warning about the risks since the early 2000s.

The classification of finasteride as a cosmetic treatment is one reason it has been difficult to monitor accurately, as none of the safety studies were conducted by the manufacturer or regulatory authorities.

Finasteride: A Cosmetic Drug with Significant Risks

Finasteride works by preventing the conversion of testosterone to dihydrotestosterone (DHT), but in doing so, it may also disrupt neurosteroids like allopregnanolone, which are linked to mood regulation in the brain. Animal studies have shown long-term effects on neuroinflammation and even changes in hippocampal structure.

Brezis’s report suggests that classifying the drug as a non-essential product for appearance improvement alters the risk assessment, as the harms are not tied to a medical necessity for life or death.

Regulatory Gaps and Corporate Silence

The report strongly criticizes both the FDA and Merck, the drug’s developer. Despite the availability of millions of patient records and robust pharmacovigilance tools, neither party took timely action. The industry’s silence was strategic, driven by market pressures and legal liabilities.

Brezis calls for immediate changes in how drugs like finasteride are approved, monitored, and prescribed. His recommendations include suspending the drug’s marketing for cosmetic purposes until its safety is re-confirmed, conducting mandatory post-approval studies with strict enforcement, and systematically recording drug histories in suicide investigations.

Conclusion

Finasteride is a well-known drug in the fight against baldness, but it carries significant mental health risks that were not widely recognized until now. Recent evidence highlights the need for a thorough review of how non-essential cosmetic drugs are handled, which can lead to serious side effects. Regulatory bodies and pharmaceutical companies must take responsibility for protecting public health through better drug approval and monitoring practices.