From the Guidelines
Finasteride is not contraindicated in patients with seizure disorders. There is no established interaction between finasteride and seizure disorders, and it does not lower the seizure threshold. Finasteride, available as 1mg (Propecia) for male pattern baldness or 5mg (Proscar) for benign prostatic hyperplasia, works by inhibiting the enzyme 5-alpha-reductase, which converts testosterone to dihydrotestosterone (DHT). This mechanism of action does not affect neural pathways involved in seizure activity. The medication is primarily metabolized in the liver and does not significantly cross the blood-brain barrier in a way that would impact seizure control.
The provided evidence [ 1, 2, 3, 4 ] discusses the increased incidence of seizures among patients with a history of seizure disorders who have received amantadine, but it does not mention finasteride. Therefore, this evidence is not relevant to the question of whether finasteride is contraindicated in patients with seizure disorders.
Patients with seizure disorders can generally take finasteride safely alongside their anticonvulsant medications. However, as with any medication, it's essential to maintain regular follow-up with healthcare providers to monitor for any unexpected side effects or interactions with other medications the patient may be taking. Key points to consider include:
- Finasteride's mechanism of action and its lack of effect on neural pathways involved in seizure activity
- The medication's primary metabolism in the liver and minimal crossing of the blood-brain barrier
- The importance of regular follow-up with healthcare providers to monitor for potential side effects or interactions.
From the Research
Finasteride Contraindications
- There is no direct evidence in the provided studies to suggest that finasteride is contraindicated in patients with seizure disorders 5, 6, 7, 8, 9.
Potential Side Effects
- Finasteride has been associated with various side effects, including loss of libido and sexual potency 5, erectile dysfunction 6, and psychiatric disorders such as depression and anxiety 7, 9.
Special Considerations
- Patients with a history of mental health conditions, such as depression or suicidal ideation, should be closely monitored while taking finasteride 7.
- Finasteride may increase the risk of psychiatric disorders, particularly in patients with androgenetic alopecia 9.
- However, the overall risk of adverse mental health effects is considered low, and finasteride can be safely used in most patients 9.