Recent reports show that, in patients treated with finasteride for male pattern hair loss, persistent side effects including sexual side effects, depression, anxiety and cognitive complaints may occur. We here explored the psychiatric and andrological features of patients affected by post-finasteride syndrome (PFS) and verified whether the cerebrospinal fluid (CSF) and plasma levels of neuroactive steroids (i.e., important regulators of nervous function) are modified. We found that eight out of sixteen PFS male patients considered suffered from a DSM-IV major depressive disorder (MDD). In addition, all PFS patients showed erectile dysfunction (ED); in particular, ten patients showed a severe and six a mild-moderate ED. We also reported abnormal somatosensory evoked potentials of the pudendal nerve in PFS patients with severe ED, the first objective evidence of a neuropathy involving peripheral neurogenic control of erection. Testicular volume by ultrasonography was normal in PFS patients. Data obtained on neuroactive steroid levels also indicate interesting features. Indeed, decreased levels of pregnenolone, progesterone and its metabolite (i.e., dihydroprogesterone), dihydrotestosterone and 17beta-estradiol and increased levels of dehydroepiandrosterone, testosterone and 5alpha-androstane-3alpha,17beta-diol were observed in CSF of PFS patients. Neuroactive steroid levels were also altered in plasma of PFS patients, however these changes did not reflect exactly what occurs in CSF. Finally, finasteride did not only affect, as expected, the levels of 5alpha-reduced metabolites of progesterone and testosterone, but also the further metabolites and precursors suggesting that this drug has broad consequence on neuroactive steroid levels of PFS patients.
Neuroactive steroid levels and psychiatric and andrological features in post-finasteride patients / R.C. Melcangi, D. Santi, R. Spezzano, M. Grimoldi, T. Tabacchi, M.L. Fusco, S. Diviccaro, S. Giatti, G. Carrà, D. Caruso, M. Simoni, G. Cavaletti. - In: JOURNAL OF STEROID BIOCHEMISTRY AND MOLECULAR BIOLOGY. - ISSN 0960-0760. - 171(2017 Jul), p. 229.235.
|Titolo:||Neuroactive steroid levels and psychiatric and andrological features in post-finasteride patients|
|Parole Chiave:||5α-Reductase; Erectile dysfunction; Major depressive disorder; Pregnenolone; Progesterone; Testosterone; Endocrinology, Diabetes and Metabolism; Medicine (all); Biochemistry; Molecular Medicine; Molecular Biology; Endocrinology; Clinical Biochemistry; Cell Biology|
|Settore Scientifico Disciplinare:||Settore MED/13 - Endocrinologia|
Settore BIO/10 - Biochimica
|Data di pubblicazione:||lug-2017|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1016/j.jsbmb.2017.04.003|
|Appare nelle tipologie:||01 - Articolo su periodico|