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Finasteride treatment and neuroactive steroid formation
Prague Medical Report
|August 7, 2009
Summary
Finasteride therapy significantly alters steroid metabolism in men with benign prostate hyperplasia. This impacts neuroactive steroid levels, potentially explaining depression side effects observed in some patients.
Area of Science:
- Endocrinology
- Neuroendocrinology
- Pharmacology
Background:
- Finasteride inhibits 5alpha-reductase, an enzyme crucial for converting testosterone to dihydrotestosterone.
- This enzyme also affects other steroid conversions, influencing neuroactive compounds that modulate GABA receptors.
- Neuroactive steroids exhibit anticonvulsant, antidepressant, and anxiolytic properties.
Purpose of the Study:
- To investigate the comprehensive effects of finasteride on the steroid hormone profile in men with benign prostate hyperplasia.
- To correlate observed hormonal changes with potential mechanisms for finasteride's known side effects.
Main Methods:
- A cohort of 20 men diagnosed with benign prostate hyperplasia was enrolled.
- Participants received a daily dose of 5 mg finasteride for a duration of 4 months.
- Steroid hormone levels were measured before and after the treatment period.
Main Results:
- Finasteride treatment led to a significant reduction in alpha-reduced steroid metabolites.
- A notable increase in 5beta-reduced metabolites of testosterone and progesterone was observed.
- Levels of 7alpha-hydroxy derivatives, known neuroactive steroids, significantly increased.
Conclusions:
- Finasteride therapy profoundly alters the balance of steroid metabolites in men with BPH.
- The observed changes include a decrease in inhibitory neuroactive steroids and an increase in others.
- These hormonal shifts may contribute to the depression symptoms reported in some individuals undergoing finasteride treatment.
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