Professional Documents
Culture Documents
2016
Marina Giurgiu
Carol Davila University, Faculty of Dental Medicine, Department of Periodontology
Andrei Vasilache
Carol Davila University, Faculty of Dental Medicine, Department of Periodontology
Ioana Paunica
Carol Davila University, Faculty of General Medicine
Ion Motofei
Carol Davila University, Faculty of General Medicine
Recommended Citation
Paunica, Stana; Giurgiu, Marina; Vasilache, Andrei; Paunica, Ioana; Motofei, Ion; Vasilache, Adriana; Dumitriu, Horia Traian; and
Dumitriu, Anca Silvia (2016) "Finasteride adverse effects and post-finasteride syndrome; implications for dentists," Journal of Mind
and Medical Sciences: Vol. 3 : Iss. 1 , Article 9.
Available at: http://scholar.valpo.edu/jmms/vol3/iss1/9
This Research Article is brought to you for free and open access by ValpoScholar. It has been accepted for inclusion in Journal of Mind and Medical
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Finasteride adverse effects and post-finasteride syndrome; implications for
dentists
Authors
Stana Paunica, Marina Giurgiu, Andrei Vasilache, Ioana Paunica, Ion Motofei, Adriana Vasilache, Horia Traian
Dumitriu, and Anca Silvia Dumitriu
This research article is available in Journal of Mind and Medical Sciences: http://scholar.valpo.edu/jmms/vol3/iss1/9
J Mind Med Sci. 2016; 3(1): 71-79. Research Article
Abstract
Finasteride is a 5-reductase inhibitor widely used in present in the therapeutic approach of
androgenic alopecia. Adverse effects consist in variable sign and symptoms, the most common being
represented by mental troubles (reduced feeling of life pleasure or emotions, depression), physical
impairments (loss of muscle tone and/or mass) and sexual complains (loss of libido and sexual
potency). An increasing number of studies identify and describe even a post-finasteride syndrome
(persistent adverse affects three months or more after finasteride cessation) or new adverse effects
including but not limited at the skin level or oral cavity (marginal periodontium).
We intend to present in this study several oral adverse effects encountered during finasteride
administration, represented by mild and moderate signs which generally responded to topical
procedures without to require the stop of the drug administration. New studies on large samples will
further document the existing relation between the described oral adverse effects and the implied
pathophysiological mechanisms. For this moment, we are taking into account as possible
hormonal interferences, or coexisting factors with finasteride administration that were not detected.
Corresponding address: spaunica@yahoo.com, Carol Davila University, Department of Periodontology, Calea Plevnei
Street, No. 17- 23, Bucharest, Romania
Finasteride adverse effects
Introduction
Recent studies show that finasteride side
Finasteride is a 5-reductase inhibitor, effects can occur at the level of oral cavity too, in
extensively used in present in the therapeutic the form of various signs and symptoms
approach of male pattern hair loss. It is approved (erythema, purpura, gingival hypertrophy) (6, 7).
only for men with androgenetic alopecia, being not The current study is aimed to present oral
indicated for women or in the case of pediatric finasteride adverse effects encountered on a
patients. Finasteride is also used for benign
sample of men taking the drug for androgenic
prostatic hyperplasia (5mg/ day), being suspected
alopecia.
that could increase the risk of high-grade prostate
cancer. In respect to androgenetic alopecia, Materials and Methods
finasteride can be administered in the form of
The study group taking finasteride was
tablets, 1mg/ day, or as topical solution applied on
represented by eighty four subjects with
the scalp once or twice a day (1-3).
androgenic alopecia, who received the drug 1 mg
Finasteride is extensively degraded to daily, six month or more. Inclusion criteria used to
inactive metabolites in liver, which are further recruit subjects were as follow: men with
eliminated through urine and bile. As active androgenic alopecia, presenting no significant
compound, finasteride prevents conversion of (mental, sexual, cutaneous, oral) affections prior
testosterone, progesterone and deoxycorticosterone the treatment, and taking no specific diets or drugs
to the corresponding metabolites, namely for general conditions (obesity, hypertension, etc.).
dihydrotestosterone (DHT), dihydroprogesterone, According to literature data, finasteride proved to
dihydrodeoxycorticosterone. All these mediators be able to induce a lot of adverse effects during
act within the brain modulating not only sexual and after administration. As a consequence, we
receptors but also the action of -aminobutyric acid designed and performed the study with several
on the corresponding GABA receptors. specialists to cover a wider field of study,
Accordingly, the most frequent adverse effects including dermatologists, psychiatrists,
induced by finasteride are related to mental psychologists, urologists, and dentists. Subjects
(depression) and sexual (loss of libido and sexual were monitored in respect to adverse effects
potency) symptoms, which are encountered not encountered not only during therapeutic phase but
only during finasteride administration but also also after treatment cessation, for at least four
after treatment cessation (as post-finasteride months.
syndrome) (4, 5).
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Paunica S. et al.
Finasteride adverse effects described in lower/ ignored if the patients would not be advised
literature differ from study to study. Thus, the (18).
genitourinary symptoms seems to be not only
A lot of adverse effects related to finasteride
physical but also functional, represented by penile
are encountered not only during Finasteride
and scrotal shrinkage and numbness, decreased
administration but also after treatment cessation, in
semen volume and force, erectile dysfunction,
the form of post-Finasteride syndrome. In other
decreased libido, and decreased or loss of orgasm
words, the post-Finasteride syndrome should be
(12, 13).
delineated (as a distinct pathophysiological entity)
Mental and neurological troubles consist in by the adverse effects which are encountered
memory impairment, decreased comprehension, during Finasteride administration. Adverse effects
depression, anxiety, suicidal thoughts, insomnia, encountered during finasteride administration
anhedonia and emotional flatness (14, 15). would be the consequences of a direct finasteride
action, and indirect consequences of subsequent
Physically, finasteride adverse effects are
hormonal interferences. After finasteride cessation,
represented by gynecomastia (female-like
adverse effects should be assigned only to the
enlargement of the breast), chronic fatigue, muscle
residual hormonal interferences, represented by
twitching and atrophy, decreased body
altered level of certain neuroactive steroids in
temperature, increased fat deposition/ elevated cerebrospinal fluid and plasma. In support of this
body mass index, cardiovascular impairments delineation between finasteride and post-
(palpitations, hypotension), dermatologic and oral finasteride adverse effects, recent studies show that
manifestations (chronically dry, pruritus, rash, the frequency of finasteride side effects (occurring
urticaria, erythema, purpura, gingival hypertrophy) during Finasteride administration) is greater in
(16, 17). right handed men, while the post-finasteride
syndrome is encountered with a similar frequency
It seems that the nature and frequency of the
in right and left handed men (7, 12, 19).
above described adverse effects depend not only
by the study design but also by the sample studied. A lot of general conditions have (in different
Just an example, it was found that the frequency of developmental stages) significant effects at the
finasteride side effects would be significantly level of oral cavity. The most notable diseases are
higher when the patients are informed (before represented by: chronic hepatitis, chronic renal
treatment) about the possible adverse effects, and diseases, chronic heart failure, venous
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