Suicidal Ideation: A Symptom of Post-finasteride Syndrome

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

What does persistent suicidal ideation from finasteride entail?

Suicidal ideation is characterized by thinking about or planning suicide. Many PFS patients report having suicidal thoughts.

It should be noted that self-reports indicate that 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 suicidal thoughts

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

“Sometimes I sit around and think about the shape I am in and all I have lost and I strongly consider suicide.“

“Since I got PFS, there hasn’t been a day that’s gone by where I haven’t thought of suicide. I had never thought of it before. Never had a reason to.“

“Sometimes I get uncontrollable, intense thoughts of ways to kill myself.”

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

While there are estimations of incidence for suicidal ideation as a side effect of finasteride, there is limited data with which to estimate the prevalence of suicidal ideation in PFS. Anecdotally however, it is one of the most common symptoms. 

Research findings on suicidal ideation 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, ablation of adequate androgen receptor function is associated with a range of symptoms that can significantly alter quality of life. Ablation of adequate androgen receptor function has also been associated with spontaneous suicidal thoughts. 

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 suicidality after finasteride go away? Is it reversible?

Some patients have reported improvements in their symptoms over time which led to a reduction in suicidality. Nonetheless, many patients report learning to manage and deal with their symptoms as time passes, which reduces suicidality. 

Managing and coping with suicidality

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

  1. Speak with a trained professional: Consider speaking with someone trained in helping others deal with thoughts of suicide. 

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

  3. 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. 

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

  5. 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 suicidal ideation or other symptoms 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 suicidality 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.

  • 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.