Finasteride and mental health: depression, anxiety and suicidal thoughts

For many men, hair thinning over time involves far more than changes to how they look. Finasteride, a medicine commonly prescribed for male pattern baldness, has been used successfully for years to address this highly personal concern.

However, its use has prompted increasing concern over possible links with depression, anxiety and suicidal thoughts.

Both people taking the medicine and healthcare professionals are now closely examining the potential risks of continued treatment.

How does finasteride function, and what does the evidence show about the likelihood of mental health problems?

How does finasteride work?

Finasteride is prescribed for androgenetic alopecia, more commonly called male pattern baldness. It can encourage hair regrowth and help prevent further hair loss.

A major contributor to pattern baldness is dihydrotestosterone, a hormone produced by the body from testosterone. When this hormone attaches to hair follicles, it triggers hair follicle miniaturisation. The hair's growth phase then becomes steadily shorter, leaving hair finer and weaker.

Finasteride blocks the enzyme responsible for converting testosterone into dihydrotestosterone. For most men, this reduces dihydrotestosterone levels by approximately 60–70%.

First authorised as a prescription-only medicine in the late 1990s, finasteride is taken as a 1 milligram tablet once a day. Medicines supplied at the higher daily dose of 5 mg are not intended for baldness; they are used to treat non-cancerous enlargement of the prostate.

Although women can experience this form of hair loss too, the medicine is not indicated for them.

How can finasteride affect mental health?

Australian guidance for healthcare professionals does not list mental health changes as an established side effect.

Clinical trials identify the following as the most common effects:

• reduced libido
• erectile dysfunction
• lower semen production.

The guidance also notes a higher risk of prostate cancer and a possible risk of breast cancer. Men can develop breast cancer as well.

Although the early clinical trials used to secure approval for the medicine did not identify mental health issues, subsequent monitoring of people using it has suggested a possible increased risk of depression and suicidal thoughts.

As these findings rely on patients reporting their own symptoms, however, the guidance states that no definitive connection has been established.

In May 2025, though, the European Medicines Agency's safety committee confirmed suicidal thoughts as a side effect of finasteride. The European Union also warns patients that finasteride may lead to low mood and depression.

Likewise, in April 2025, the United States Food and Drug Administration warned that compounded finasteride in topical forms has side effects similar to those of the oral medicine. These include depression, anxiety and suicidal thoughts.

What should you do if finasteride affects your mental health?

If you experience mental health changes while using the medicine, do not try to manage major mood changes alone. If you feel unusually low, anxious or emotionally unsettled, speak to a doctor. They can help assess whether finasteride may be affecting your mood and identify any support you might require.

For mild symptoms, a doctor might recommend stopping finasteride temporarily to check whether you improve, or carrying on with extra mental health support. More serious symptoms may require stopping the medicine and seeking a medical assessment promptly.

If you use finasteride and are concerned about side effects, you can stop taking it immediately. Most side effects improve after the medicine has left your body, although a small number of people have reported lasting symptoms.

Stopping treatment means your hormone levels will slowly return to their usual baseline, and any hair growth gained from the medicine will gradually be lost.

If finasteride does not suit you, another evidence-based option is available.

Topical minoxidil is a first-line treatment that may be used alone or alongside other treatments, and it can be bought over the counter at pharmacies. It works only for as long as it is applied and can irritate the scalp, but its effectiveness is well established and it is widely recommended.

Depression and anxiety have been associated with minoxidil, but they occur far less often because it is applied topically.

Dutasteride is another medicine. However, because it acts in a similar manner to finasteride, it may also raise the risk of mental health problems. Dutasteride is therefore best avoided if finasteride is unsuitable for you.

Nial Wheate, Professor, School of Natural Sciences, Macquarie University and Jasmine Lee, Pharmacist and PhD Candidate, University of Sydney

This article is republished from The Conversation under a Creative Commons licence. Read the original article.

If this story has raised concerns or you need to talk to someone, please consult this list to find a 24/7 crisis hotline in your country, and reach out for help.