Introduction: Observations performed in a subset of subjects treated with finasteride (an inhibitor of the enzyme 5α-reductase) for male pattern hair loss seem to indicate that sexual dysfunction, as well as anxious/depressive symptomatology, may occur at the end of the treatment and continue after discontinuation.
Aim: A possible hypothesis to explain depression symptoms after finasteride treatment might be impairment in the levels of neuroactive steroids. Therefore, neuroactive steroid levels were evaluated in paired plasma and cerebrospinal fluid samples obtained from male patients who received finasteride for the treatment of androgenic alopecia and who, after drug discontinuation, still show long-term sexual side effects as well as anxious/depressive symptomatology.
Conclusion: The present observations confirm that an impairment of neuroactive steroid levels, associated with depression symptoms, is still present in androgenic alopecia patients treated with finasteride despite the discontinuation of the treatment.
Melcangi RC, Caruso D, Abbiati F, Giatti S, Calabrese D, Piazza F, Cavaletti G, et al. Neuroactive steroid levels are modified in cerebrospinal fluid and plasma of post-finasteride patients showing persistent sexual side effects and anxious/depressive symptomatology. Expert Opin Drug Saf. 2013 Jan;12(1):81-90. doi: 10.1517/14740338.2013.742885. Epub 2012 Nov 22. [PubMed]