Anxiety: A Symptom of Post-finasteride Syndrome

In this article we review what anxiety is, how it presents in PFS, and the resources and support available for patients experiencing this symptom. 

What does anxiety or panic attacks from finasteride entail?

Anxiety is an intense feeling of fear or dread, often accompanied by physical responses such as increased heart rate, sweating, or rapid breathing. A panic attack is an episode of intense anxiety with intense physical responses. Many PFS patients report experiencing anxiety, to varying degrees. 

It should be noted that self-reports indicate it can take up to 3 months for on-drug side effects to resolve after discontinuation of finasteride. After that, the symptoms can be considered persistent. 

How PFS patients describe the effects of anxiety and panic attacks

Here are some descriptions from patients based on documented interviews and stories: 

“I have a constant feeling of dread or unease.“

“I also had sudden panic attacks that started just a few weeks into taking finasteride. I would wake up in the middle of the night, gasping for breath, and then I would feel like I couldn’t breathe right for a while afterwards.“

How common is anxiety as a symptom of Post-finasteride Syndrome?

While there may be estimates of incidence for anxiety as a side effect of finasteride, there is limited data with which to estimate the prevalence of anxiety in PFS.  

Research findings on anxiety and panic attacks in PFS 

Two separate studies have found an overexpressed androgen receptor in affected tissue from PFS patients (Di Loreto et al. 2014; Howell et al. 2021), and in addition one of them examined for and found concurrent differential expression of several thousand genes (Howell et al. 2021). Notably, the androgen receptor serves as an anxiolytic (anti-anxiety agent) when functioning adequately. 

It is essential to note that more research into post-finasteride syndrome is desperately needed. PFS is currently without an accurate animal model, pathomechanistic understanding, and as a result, safe and effective treatment. 

Does persistent anxiety after finasteride go away? Is it reversible?

Some patients have reported improvements in anxiety or panic attacks over time. However, PFS is understood to persist indefinitely, and it is currently without safe and effective treatment. 

Managing and coping with anxiety

For those who may be struggling with symptoms, here are some general recommendations:

  1. Focus on self-care: Try to find routines and activities that help you personally.

  2. Be practical about your life situation and/or relationships: Try not to think too far ahead and catastrophize. PFS affects individuals to different degrees and some experience improvements over time. 

  3. Familiarize yourself with the scientific literature: Read through previous research into PFS on our website in order to better understand your condition.

  4. Support research: Further research into PFS, based on a theory and/or conceptualization of the condition that is backed by all previous research findings and can plausibly explain all symptoms reported by patients, is the only way toward a treatment.

What about supplements or other drugs to help treat symptoms?

There are currently no evidence-based items recommended for treatment of anxiety stemming from PFS. In general, patients have reported worsening by attempting to treat their symptoms with anti-androgenic substances (including SSRIs and SNRIs). We are obligated to make patients aware as this has preceded patient suicide.  

Next steps 

If you or a family member is experiencing anxiety from finasteride, there are multiple resources available to you and ways you can help:

Learn more about Post-Finasteride Syndrome 

  • Read our Frequently Asked Questions page.

  • Inform your physician. PFS Network provides resources to help patients discuss PFS symptoms with their clinicians. Not sure about how to start the conversation? Start here.

  • Read about previous studies of PFS. 

  • Experiencing other symptoms? You can find information on other persistent side effects from finasteride here.

Help us fund research 

  • Consider donating to help fund our research projects. The best and easiest way to support research into PFS is through a monthly recurring donation. Every amount matters. 

  • Learn more about our ongoing research projects.

Report your symptoms

  • Refer to your country’s pharmacovigilance organization by reviewing our regulatory list, or by consulting the World Health Organization’s (WHO) list of reporting resources here: https://who-umc.org/ (Scroll to the bottom to select your country from the map provided).

Stay up-to-date

  • Sign up for our mailing list to stay up to date on research and news related to PFS: Email sign-up

  • View and subscribe to our YouTube channel. You may also consider appearing on our patient interview series. 

Connect with other PFS patients

  • Follow our Patient Stories & Interviews to hear how others have experienced similar symptoms of anxiety.

  • Join our community forums. PFS Network operates the largest and longest-running standalone patient forum, propeciahelp.com, where patients can connect with others affected by adverse reactions to finasteride. The charity also operates r/FinasterideSyndrome on Reddit.