Depression is a known side effect of Propecia (finasteride) and has been a warning on the label since 2010. Recent studies suggest that Propecia depression may be very severe — in some cases, depression may lead to suicidal behavior.
Propecia (finasteride) is a medication that treats male-pattern baldness by inhibiting the enzyme 5 alpha-reductase. This enzyme is involved in the conversion of testosterone to the highly-potent dihydrotestosterone (DHT), and men who are taking Propecia may have 75% less DHT than normal. Unfortunately, this significant change to a man’s hormonal system could have unintended side effects — including sexual dysfunction, depression, and physical changes.
Experts know that androgens such as DHT undergo extensive metabolism in the brain, which could affect sexual and also non-sexual functions of the brain.
Depression is a reported side effect of Propecia, and the label on Propecia has carried this warning since 2010. However, it is unknown whether Propecia causes depression or how Propecia influences depressive behavior. Some cases of depression may occur as an indirect result of severe sexual dysfunction.
Studies of Propecia and Depression
August 7, 2012 — This study published by Dr. Michael Irwig of George Washington University investigated depression and suicidal behavior among 61 men who were also suffering from persistent sexual dysfunction caused by Propecia or Proscar (finasteride). Dr. Irwig found that the majority of these men also had symptoms of depression — 11% had mild symptoms, 28% had moderate symptoms, 36% had severe symptoms, and 44% reported suicidal thoughts. This study emphasizes the serious nature of depression and the life-threatening risk of suicide.
October 2006 — This study investigated 128 men who were prescribed Propecia to treat male-pattern baldness. They concluded that Propecia might induce depressive symptoms, and it should be prescribed cautiously to people with a history of depression.
What is Depression?
Depression is a psychological illness that occurs when feelings of sadness, helplessness, hopelessness, and worthlessness last for many weeks or months and interfere with normal daily functioning. Many people have these feelings temporarily at some point in life, such as after the death of a family member or another major crisis.
In some cases, depression is a sequelae of another side effect of a medication. Other times, it is directly caused by biological changes in the brain and body chemistry due to a medication.
Symptoms of Depression
The symptoms of depression vary from person to person. They can be very mild, or severely debilitating. A key symptom is depressed mood and a lack of interest in activities that were once enjoyed. Symptoms may include:
- Feeling sad, unhappy, hopeless, or inadequate
- Feelings of worthlessness or guilt
- Irritation or frustration, may be over small matters
- Loss of interest in normal activities
- Decreased sex drive
- Changes in sleep patterns
- Changes in appetite
- Agitation, restlessness, pacing
- Aggressive outbursts
- Slow thinking, speaking, or body movements
- Decreased concentration
- Distractibility, indecisiveness, inability to remember things, or think
- Thoughts of death, dying, or suicide
- Crying for no reason
- Back pain or headaches
Propecia Side Effects
Propecia has also been linked to the following side effects:
- Sexual side effects
- Male breast cancer
- High-grade prostate cancer
- Loss of Libido
- Erectile dysfunction
- Emotional trauma
- Body disfigurement
- Decreased muscle mass
- Endocrine system failure
- Penile fibrosis
- Genital shrinkage
- Post-Finasteride Syndrome