Post-finasteride syndrome: a surmountable challenge for clinicians.

@article{Traish2020PostfinasterideSA,
  title={Post-finasteride syndrome: a surmountable challenge for clinicians.},
  author={Abdulmaged M. Traish},
  journal={Fertility and sterility},
  year={2020},
  volume={113 1},
  pages={
          21-50
        }
}
  • A. Traish
  • Published 1 January 2020
  • Medicine, Psychology
  • Fertility and sterility
How routine pharmacovigilance failed to identify finasteride's persistent sexual side effects
TLDR
Internal documents from Merck were made public thanks to a motion filed by Reuters in 2019, to unseal documents from litigation, shed light on what Merck knew and when they knew it on the persistent adverse sexual effects of finasteride.
Post-Finasteride Syndrome - When will we Get the Courage to Fight the Dictating Pharma Industry - Despite Awareness of "Sexual, Neurological and Metabolic Side Effects in Young Men for Over a Decade"
TLDR
This comprehensive review has been done with an effort for the medical community who took hippocratic oath to serve the humanity why they cannot get up and protest against the side effects that in a subgroup of men might get irreversible side effects rather than label the poor men as psychotic or delusional.
Sexual, physical, and overall adverse effects in patients treated with 5α-reductase inhibitors: a systematic review and meta-analysis
TLDR
The overall use of 5ARIs significantly increased the risk of PFS-like adverse effects in men with AGA or BPH during treatment, and this meta-analysis helped to better define the adverse effects caused by 5 ARIs.
Finasteride for hair loss: a review
TLDR
Finasteride is shown to be reasonably tolerated in both men and women; however, patients need to be educated about the possible short- and long-term side-effects.
Risk of Depression Associated With Finasteride Treatment
TLDR
The findings support a growing impression thatfinasteride is associated with adverse psychiatric effects that can persist in association with sexual dysfunction after discontinuing finasteride treatment.
Are finasteride-related penile curvature/Peyronie’s disease Adverse Event Reports worthy of further clinical investigation? Disproportionality analysis based on both the Food and Drug Administration (FDA) and the European Medicines Agency (EMA) pharmacovigilance databases
TLDR
It is found that penile curvature/PD reports were not part of a syndromic cluster suggestive of post-finasteride syndrome (PFS), and the PRR values here identified should be interpreted as strong signals of disproportionality.
Health Risks Associated with Long-Term Finasteride and Dutasteride Use: It's Time to Sound the Alarm
  • A. Traish
  • Medicine, Biology
    The world journal of men's health
  • 2020
TLDR
It is suggested that long-term use of finasteride and dutasteride may be associated with health risks including NAFLD, IR, T2DM, dry eye disease and potential kidney disease and this treatment may result in development of non-alcoholic fatty liver diseases (NAFLD), insulin resistance (IR), type 2 diabetes (T2DM),dry eye disease, potential kidney dysfunction, and metabolic dysfunctions.
Sexual Dysfunctions Related to Drugs Used in the Management of Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: A Narrative Review on α-Blockers and 5-Alpha Reductase Inhibitors
TLDR
A critical review of the current literature data about sexual dysfunction as a potential side effect related to drugs commonly used for the treatment of Benign Prostatic Hyperplasia and Lower Urinary Tract Symptoms finds that silodosin appears to have the highest incidence of ejaculatory disorders.
PD49-02 MEDICATIONS MOST COMMONLY ASSOCIATED WITH ERECTILE DYSFUNCTION: EVALUATION OF THE FOOD AND DRUG ADMINISTRATION NATIONAL PHARMACOVIGILANCE DATABASE
TLDR
In a national pharmacovigilance database, 5-ARIs and neuropsychiatric medications had the highest reports of ED adverse effects and Physicians should be familiar with these medications and understand their respective mechanisms of action, so that they may counsel patients appropriately and improve their quality of life.
Platelet-rich Plasma for Androgenetic Alopecia Treatment: A Randomized Placebo-controlled Pilot Study.
TLDR
Treatment with platelet-rich plasma as a monotherapy does not improve hair growth in men with androgenetic alopecia, and no improvements were seen over the course of the trial.
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References

SHOWING 1-10 OF 216 REFERENCES
A Comment on the Post-Finasteride Syndrome
TLDR
It is as inappropriate to dismiss the condition, as it would be to demonize finasteride for the treatment of male pattern hair loss, while the best way to alleviate the emotional distress related to hair loss is to effectively treat the condition causing the problem.
Post-Finasteride Syndrome: An Induced Delusional Disorder with the Potential of a Mass Psychogenic Illness?
TLDR
The first case of PFS in a long-standing dermatotrichological practice with frequent finasteride prescription observed in a 25-year-old male following dutasteride treatment for male androgenetic alopecia is reported.
Persistent sexual side effects of finasteride: could they be permanent?
  • M. Irwig
  • Psychology, Medicine
    The journal of sexual medicine
  • 2012
TLDR
In most men who developed persistent sexual side effects despite the discontinuation of finasteride, the sexual dysfunction continued for many months or years, which should be made aware of the potential adverse medication effects.
Post-finasteride syndrome – does it really exist?
TLDR
The prolonged use of 5α-steroid reductase inhibitors in patients with alopecia can cause persistent side effects called a post-finasteride syndrome (PFS), that is not just a simple coexistence of events, but rather a definite syndrome with an iatrogenic background.
Persistent Sexual and Nonsexual Adverse Effects of Finasteride in Younger Men.
  • M. Irwig
  • Medicine, Psychology
    Sexual medicine reviews
  • 2014
TLDR
Persistent adverse effects of finasteride in younger men include erectile dysfunction, low libido, lack of orgasms, depression, and decreased alcohol consumption.
Neuroactive steroid levels and psychiatric and andrological features in post-finasteride patients
Post-finasteride syndrome and post-SSRI sexual dysfunction: two sides of the same coin?
TLDR
The present review will report the state of art of these two different pathologies and discuss, on the basis of the role exerted by three different neuromodulators such as dopamine, serotonin and neuroactive steroids, whether the persistent sexual dysfunction observed could be determined by common mechanisms.
Enduring sexual dysfunction after treatment with antidepressants, 5α-reductase inhibitors and isotretinoin: 300 cases
TLDR
Clinical reports of post-SSRI sexual dysfunction, post-finasteride syndrome and enduring sexual dysfunction following isotretinoin point to a legacy syndrome or syndromes comprising a range of disturbances to sexual function.
Post-Finasteride Syndrome: About 2 Cases and Review of the Literature
TLDR
Post-finasteride syndrome is a little known entity with an unknown physiopathology, and is currently under study and awareness should be promoted about the existence of this syndrome in order to give the best assistance to patients until the authors have a better comprehension of this entity.
Persistent sexual side effects of finasteride for male pattern hair loss.
TLDR
The types and duration of sexual dysfunction and the changes in perceived sexual frequency and sexual dysfunction score between pre- and post-finasteride use are characterized.
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