Post-Finasteride Syndrome: Current Views and Where do we Stand?

Author(s):

Ghadah I Alhetheli*, Fahad Hamoud Alrashidi and Saleh H Alhammad

Introduction: Androgenetic alopecia is the most frequent cause of hair loss worldwide, affecting around 70% of males and 40% of females. Since the approval of finasteride for androgenetic alopecia, several studies have reported various psychological and sexual side effects. In 2012, the food and drug organization made changes to the drug insert stating the possibility of persistent side effects, or what is known as post-finasteride syndrome. There is still not much known about the rate of these side effects and the causal relationship. Methods: A literature search was performed using the Pubmed and Google Scholar databases that included studies conducted from 1995 to 2020. Results: There were 47 identified articles in Pubmed, while 152 articles were identified using Google Scholar. Duplicates were removed, leaving a total of 185 articles. Following a second, thorough screening of the titles and abstracts, only 62 full-text articles were reviewed. Of those, 35 articles were chosen to be included. Conclusion: Based on the existing literature, the medical community believes that these patterns of symptoms constitute the basis for PFS in individuals predisposed to epigenetic susceptibility. The medical community must define and characterize the pathophysiological mechanisms underlying PFS, and more attention should be devoted to patient education and counseling as well as to developing novel management modalities. Further highquality clinical studies are needed to evaluate the potential neuropsychiatric side effects of finasteride in humans and to establish whether finasteride has any exact causal relationship with suicidal ideation and other reported side effects.

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