Propecia, a drug used to fight male-pattern baldness, can cause long-lasting sexual dysfunction and depression. (National Library of Medicine / National Institutes of Health / August 8, 2012) |
Using Propecia -- generically known as finasteride -- to promote hair growth for baldness can lead to sexual dysfunction and severe depression, even long after use of the drug is stopped, a researcher reported Wednesday.
The Food and Drug Administration recently required relabeling of Propecia to indicate concern about such side effects, but the new study suggests that the depression is more severe than had been thought.
It's not known how many men suffer from loss of libido and erectile dysfunction after using the drug, but it is thought to be no more than a few percent. It is also not clear how long the effects can persist after the drug is stopped.
Dr. Michael S. Irwig, an endocrinologist at George Washington University in Washington, D.C., studied 61 former users of Propecia who had suffered sexual side effects for at least three months and compared them with a group of healthy balding men who had never used it and had no psychiatric symptoms. The average age of the Propecia users was 31, compared with an average age of 26 in the control group. The average length of treatment with Propecia was 27 months. All were given a standard written survey called the Beck Depression Inventory II.
Irwig reported in the Journal of Clinical Psychiatry that moderate or severe depressive symptoms were present in 64% of the former Propecia users, but in none of the control group. About 44% of the Propecia users reported having suicidal thoughts, compared to 3% of the control group.
Finasteride can cross the blood-brain barrier and is known to interfere with the activity of the gamma-aminobutyric acid neurotransmitter system, which has been implicated in anxiety and depression.
Irwig said that physicians and patients should be aware of the potential problems associated with Propecia, "especially as it is being used cosmetically, to alter a normal age-related process."
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