Anecdotal evidence of Finasteride depression is increasingly common online, and some studies have found evidence of this adverse reaction [1]. This was concerning enough for the MHRA to recommend vigilance regarding potential psychiatric Finasteride side effects. However, only 281 reports of depressed mood disorders related to this medication have been recorded by the MHRA between 1993 and 2024 [2].
So can Finasteride really cause depression, or is it a mere coincidence? This article explores the complex answer to this question, providing expert insight on the following:
Finasteride is one of the world’s most prescribed hair loss medications. It works by reducing the activity of an enzyme called 5-alpha reductase, which converts some of the male hormone testosterone found in the human body into dihydrotestosterone (DHT) [3].
DHT is a different androgen which plays a role in sexual and reproductive function, but at the same time, it can bind to specific androgen receptors in hair follicles. This makes the affected follicles shrink, leading to hair miniaturisation and, eventually, to hair loss in a specific pattern, known as male pattern baldness (or, respectively, female pattern baldness).
Most patients taking this medication use oral Finasteride 1mg, best known under the brand name Propecia. However, others prefer topical finasteride, which can be found as a solution, gel, foam or spray. Both kinds of medication appear to be effective, but the topical variety has significantly fewer systemic side effects [4].
There have been numerous anecdotal accounts of self-reported mood disorders associated with Finasteride use (including depression, anxiety and, rarely, suicidal thoughts). However, only a limited amount of research has been conducted on the link between Finasteride and these psychiatric issues, and results are mixed.
A 2021 meta-analysis shows a slightly increased risk of depressive symptoms associated with Finasteride use (3.33% in the treatment groups vs 2.54% in the placebo groups) [1]. On rare occasions, suicidal thoughts can also occur. This prompted the MHRA to issue a warning in 2024 regarding the risk of psychiatric side effects in Finasteride users [2].
However, a more recent study conducted in 2024 on a total of over 2.2 million users found “no evidence of an association between 5-ARI [meaning 5-alpha-reductase inhibitors such as Finasteride] exposure and the risk of depression or suicide” [5]. Similarly, a 2023 French national cohort study revealed no increased suicide risk in Finasteride users with no history of mental illness [6].
The findings of a study conducted in 2025 [7] may help shed some light on this issue. Researchers analysed data from the United States Food and Drug Administration Adverse Event Reporting System (FAERS) over several time periods (2006-2011; 2013-2018; 2019-2023). They found no significant correlation between Finasteride use and depression or suicidal ideation reports between 2006-2011, but discovered an increasing number of depressive symptoms reports in the following two time frames.
This supports the notion that as people started learning about the supposed side effects of this medication, they started experiencing a nocebo effect (discussed below) [8][9].
It may sound strange for a hair growth medication to have the capacity to affect your mental health. However, there are several reasons why Finasteride use may be linked to depressive symptoms. Here are the most common.
Some researchers believe that there may be a physiological link between Finasteride use and depression. They propose that this medication can affect the level of certain neuroactive steroids in the brain, which are responsible for both sexual function and mood regulation.
Symptoms consistent with post-Finasteride syndrome (to be discussed) are also found in patients with a neuroactive steroid deficiency. However, further evidence is needed to verify this theory [10][11].
The nocebo effect is a psychological phenomenon where a patient who is hyperaware and afraid of a treatment’s potential side effects is more predisposed to experiencing them [12].
Research conducted on this topic showed that 43% of patients who were told about sexual side effects reported experiencing them, compared to only 15.3% of those who had not been informed of them [13][8].
This means that at least some of the patients reporting mood disorder symptoms after Finasteride use may be experiencing the nocebo effect.
People with a history of mental illness may be more sensitive to the psychiatric effects of Finasteride. Alternatively, they may attribute an episode of depression, anxiety or suicidal thoughts to its use, when it may be a mere coincidence. It is difficult to isolate the cause of depressive symptoms, especially when they are not unusual in a patient.
Research shows that hair loss can cause a profound psychological impact, sometimes leading to depression, anxiety, low self-esteem and social isolation [13]. Men who start Finasteride treatment for the first time are likely to have recently come to terms with the reality that they are losing their hair. The negative psychological occurrences may thus be a result of the hair loss rather than the treatment.
Some men experience sexual side effects from Finasteride, such as erectile dysfunction, diminished libido or ejaculation dysfunction. These are known to cause depressive symptoms [14]. It is easy to also attribute the depressive symptoms to Finasteride rather than sexual dysfunction.
Normally, side effects associated with Finasteride (depressive symptoms included) are temporary and can be expected to subside within a few months of treatment [15]. Moreover, research shows that stopping treatment results in a full and prompt resolution of the depressive symptoms within 3 days to 3 months [16][17].
If you have been experiencing Finasteride depression for longer than 6 months or have stopped treatment for longer than 3 months and your depressive symptoms persist, be sure to see a mental health professional for assessment if you haven’t done so already.
A very small number of people who underwent Finasteride treatment report still having depression and sexual side effects for months and sometimes years after they stopped taking the medication (some even after 11 years). This phenomenon has been dubbed post-Finasteride syndrome [18][11].
The scientific community is divided when it comes to this syndrome. Some believe it is real, based mostly on the large number of reports compared to other hair loss medications. Others believe these reports are the result of the nocebo effect, combined with health conditions or medications that can predispose to mood disorders and sexual side effects [19][11].
As medications go, Finasteride is considered safe, and there isn’t enough evidence to ascertain that it can produce any permanent side effects. You can rest assured that for the vast majority of patients, any psychiatric side effects of this medication are temporary and subside with treatment cessation.
According to the MHRA, between 1993 and 2024, there have only been 281 reports of Finasteride-related depression or suicidal thoughts [2] among the tens of thousands of UK patients who take this medication monthly [20].
While anxiety is sometimes reported alongside depressive symptoms in Finasteride users, no specific research has been conducted to quantify how common this specific side effect is. That may be because it is difficult to isolate treatment-induced anxiety from anxiety regarding potential side effects or treatment effectiveness. We only know that 34% of the men who report post-Finasteride syndrome experience this symptom [6].
Research shows that certain categories of patients may be more predisposed to experience Finasteride depression [21]:
The best way to reduce your risk of serious Finasteride side effects, including depression, is to try using topical instead of oral Finasteride. That is because while it can be as effective against hair loss as the oral drug, the solution doesn’t normally enter your bloodstream in quantities high enough to cause systemic side effects, such as depression [22].
Other methods to reduce the chance of developing Finasteride side effects include being fully open with your prescribing doctor regarding your existing conditions and medications and taking your Finasteride exactly as prescribed. Keeping an open mind and a positive attitude about your treatment can also help reduce the likelihood of experiencing a nocebo effect.
If you are experiencing persistent depressive symptoms, regardless of the cause, it is a good idea to see your GP or a mental health professional. Let them know you are using Finasteride, share your symptoms and follow their recommendations.
If you are feeling suicidal or fear you might harm yourself, contact emergency services immediately. They are trained to provide the vital assistance you need to find relief.
Besides psychiatric side effects, some men who use Finasteride for hair loss have also reported other adverse reactions when taking this medication, including [23][16]:
Moreover, premenopausal women can’t normally use Finasteride, as it can cause foetal malformations, as well as hormonal imbalances.
If you are experiencing a type of alopecia and are unsure what treatment is the safest and most effective for you, we are here to help. Book a consultation with one of our experienced trichologists, and they will explain the side effects of all medications effective for your kind of hair loss. They will help you weigh the pros and cons of each available option, allowing you to make a safe and informed decision.
If there are still things that remain unclear about the psychiatric side effects of Finasteride, you may find the answers you need in the FAQ section below.
Most patients report the onset of depression during the first 5 months of Finasteride treatment. One study found the onset of depressive symptoms to occur between 9 and 19 weeks of first taking oral Finasteride [17].
More evidence is needed to determine whether Finasteride can really increase your risk of suicide, as existing research provides mixed results [6][5]. To this day, only very few cases of suicidality linked to Finasteride use have been reported among millions of users worldwide.
However, if you have a history of mental illness (especially involving suicidal thoughts or attempts), be sure to let your prescribing doctor know before taking this treatment [24]. They can determine the risk-benefit ratio in your specific case and provide the right recommendations to keep you safe.
At this time, there is no evidence that Finasteride can affect human serotonin levels. There is an indication it may do so indirectly in male rats, through reducing the levels of certain neurosteroids that can affect serotonin production [25]. However, people’s physiology differs significantly from that of rats, so human trials are needed to prove this effect.
If you are currently diagnosed with clinical depression, it may be safest to try a different hair growth treatment, such as Minoxidil or a hair transplant. However, this is a matter that is best discussed with your mental health provider, who knows all the specifics of your condition.
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