In this postmarketing case series of 6 former finasteride users who committed suicide, all reported insomnia and persistent sexual dysfunction after medication discontinuation. The most prominent psychiatric symptoms were depression, anxiety, panic attacks, feelings of isolation and “brain fog.” Some of the most debilitating symptoms were insomnia and fatigue. Apart from 1 case who had hyperlipidemia, there is no documentation of concomitant medication use with finasteride or any baseline medical or psychiatric diagnoses prior to starting finasteride... In summary, among the men who committed suicide in the setting of finasteride treatment for alopecia, the most debilitating symptoms were insomnia, fatigue, depression, anxiety and isolation. Clinicians should be aware that men under the age of 40 who use finasteride for alopecia are at risk for suicide if they develop persistent sexual adverse effects and insomnia.
Irwig, MS: 2020 Jan 14:1-6. doi: 10.1159/000505151: [Dermatology]