Safety Profile of Finasteride: Distribution of Adverse Effects According to Structural and Informational Dichotomies of the Mind/Brain.
Finasteride is currently used extensively for male androgenic alopecia and benign prostatic hyperplasia; however, some adverse effects are severe and even persistent after treatment cessation, the so-called 'post-finasteride syndrome'. The following most severe adverse effects-sexual dysfunction and depression-often occur together and may potentiate one other, a fact that could explain (at least in part) the magnitude and persistence of finasteride adverse effects. This paper presents the pharmacological action of finasteride and the corresponding adverse effects, the biological base explaining the occurrence, persistence and distribution of these adverse effects, and a possible therapeutic solution for post-finasteride syndrome. The distribution of finasteride adverse effects is presented within a comprehensive and modern neuro-endocrine perspective related to structural and informational dichotomies of the brain. Understanding the variation of finasteride side effects among different populations would be necessary not only to delineate the safety profile of finasteride for different subgroups of men (a subject may or may not be affected by a certain anti-hormonal compound dependent on the individual neuro-endocrine profile), but also as a possible premise for a therapeutic approach of finasteride adverse effects. Such therapeutic approach should include administration of exogenous hormones, which are deficient in men with post-finasteride syndrome, namely dihydrotestosterone (in right-handed men) or progesterone/dihydroprogesterone (in left-handed subjects).
Department of Psychiatry, Carol Davila University, Cazangiilor Street No. 10, 033063, Bucharest, Romania. igmotofei@yahoo.com.
Ion G
http://orcid.org/0000-0003-4495-6541
IG
Motofei
Department of Psychology, Valparaiso University, Valparaiso, IN, 46383-6493, USA.
David L
DL
Rowland
Department of Psychiatry, Carol Davila University, Cazangiilor Street No. 10, 033063, Bucharest, Romania.
Mirela
M
Manea
Department of Dermatology, Carol Davila University, Bucharest, Romania.
Simona R
SR
Georgescu
Department of Psychiatry, Carol Davila University, Cazangiilor Street No. 10, 033063, Bucharest, Romania.
Ioana
I
Păunică
Department of Urology, Carol Davila University, Bucharest, Romania.
Ioanel
I
Sinescu
D058891:5-alpha Reductase Inhibitors / Q000009:adverse effects*; D000505:Alopecia / Q000188:drug therapy; D001921:Brain / Q000187:drug effects*; D003071:Cognition / Q000187:drug effects; D018120:Finasteride / Q000009:adverse effects*; D006801:Humans; D008297:Male; D011470:Prostatic Hyperplasia / Q000188:drug therapy; D012725:Sexual Behavior / Q000187:drug effects
D058891:5-alpha Reductase Inhibitors; D018120:Finasteride