Baldness Treatment Drugs May Raise Risk of Depression But Not Risk of Suicide in Older Men

Atlanta, GADrugs such as Propecia and Proscar, which are used to treat male pattern baldness and enlarged prostate, may raise the risk of depression and self-harm in older men but not increase their risk of suicide, a new study found.

Both US and Canadian consumers have filed lawsuits against Merck & Co., the maker of Propecia (finasteride), claiming that the medication causes serious side effects that include a risk of sexual dysfunction and potential mental and emotional problems.

Before the FDA approved finasteride for use in treating hair loss in 1997, the drug was used, and continues to be used, as an enlarged prostate treatment. After the FDA approved Propecia, the medication came with a warning of possible side effects that included decreased libido and erectile dysfunction.

In some cases, Propecia lawsuit plaintiffs allege that the baldness treatment's long-term side effects such as sexual dysfunction, insomnia and emotional symptoms persisted for years after they stopped taking Propecia.

According to WebMD, the study, which was published in March 2017 in JAMA Internal Medicine, tracked data on more than 93,000 Canadian men aged 66 and older who had started a 5-a reductase inhibitor (5ARI) medication between 2003 and 2013.

Even though the study wasn't designed to prove cause-and-effect, WebMD reported that some psychiatric trends were seen: "The men had an 88 percent increased risk of self-harm in the first 18 months of starting on 5ARIs, but that risk disappeared after that point. Their risk of depression rose by 94 percent during the first 18 months and continued to be elevated after that, but to a much lesser degree, the findings showed."

However, WebMD also reported that the study found no elevation in suicide risk for men taking male pattern baldness drugs such as Propecia and Proscar.

An earlier study, Characteristics of Men Who Report Persistent Sexual Symptoms After Finasteride Use For Hair Loss," which was published in The Journal of Clinical Endocrinology & Metabolism showed that the former finasteride users in the study had impaired sexual function, higher depression scores, a more negative affectivity and more cognitive complaints than men in the study who had never used finasteride and others who used finasteride but reported no sexual side effects.

That study also called for larger prospective studies on former finasteride users: "It is possible that the depressive symptoms and prior finasteride use are coincidental or that the depressed mood may contribute to sexual dysfunction. It is unclear why only a subset of finasteride users experience persistent sexual symptoms and low mood."