For many men, experiencing hair loss can lead to more than just aesthetic concerns. The medication finasteride, commonly prescribed for male pattern baldness, has been effective for years. However, increasing scrutiny surrounds its potential links to serious mental health issues, including depression and suicidal thoughts. This has sparked vital discussions among users and healthcare professionals regarding the risks associated with its ongoing use.
Understanding Finasteride’s Mechanism
Finasteride is primarily used to treat androgenetic alopecia, also known as male pattern baldness. It works by blocking the production of dihydrotestosterone (DHT), a hormone derived from testosterone that contributes to hair follicle miniaturization. This process shortens the hair growth cycle, leading to thinner and weaker hair.
By inhibiting the enzyme responsible for converting testosterone to DHT, finasteride can reduce DHT levels by approximately 60–70% in most men. The medication was first approved in the late 1990s as a prescription-only treatment, typically taken in a daily dose of 1 milligram. Higher doses of 5 milligrams are used for conditions like benign prostatic hyperplasia but are not indicated for hair loss. Notably, finasteride is not recommended for women, even though they can also experience similar hair loss.
Mental Health Concerns Linked to Finasteride
Despite its popularity, mental health changes are not listed as established side effects in Australian guidelines for healthcare professionals. Initial clinical trials did not indicate mental health risks. However, ongoing patient monitoring has raised concerns about potential links between finasteride and increases in depression and suicidal thoughts.
In May 2025, the European Medicines Agency (EMA) safety committee confirmed suicidal thoughts as a side effect of finasteride after reviewing accumulated data. Furthermore, the European Union now advises that finasteride may induce depression and mood changes. The United States Food and Drug Administration (FDA) echoed these concerns in an April 2025 warning regarding compounded finasteride, stating that its topical forms share similar mental health risks.
If users notice changes in their mental health while on the medication, it is vital not to address these feelings in isolation. Consulting a healthcare professional can provide clarity on whether finasteride is influencing mood and what support options are available. For mild symptoms, a healthcare provider may recommend pausing the medication to assess improvements or incorporating additional mental health support. In cases of severe symptoms, discontinuing finasteride and seeking prompt medical evaluation may be necessary.
Stopping finasteride is generally safe, and most side effects diminish once the drug leaves the system. However, some individuals have reported persistent symptoms. Discontinuation will lead to a gradual return of hormone levels to baseline, resulting in the eventual loss of any hair regrowth achieved while on the medication.
For those who find finasteride unsuitable, alternatives exist. Topical minoxidil is a first-line treatment that can be used independently or alongside other therapies. Though it may cause scalp irritation, its effectiveness is well-documented and recommended. While minoxidil is also associated with depression and anxiety, these occurrences are significantly lower due to its topical application.
Another option is dutasteride, which functions similarly to finasteride. However, given its potential to also elevate mental health risks, it may not be advisable for individuals who experience issues with finasteride.
The insights provided by experts such as Nial Wheate, Professor at Macquarie University, and Jasmine Lee, a pharmacist and PhD candidate at the University of Sydney, underline the importance of careful consideration when using finasteride.
If you or someone you know is struggling with mental health issues related to finasteride, it is crucial to reach out for help. Consult a healthcare professional or contact a local crisis hotline for support.
