Treatment of Tourette’s Syndrome With Finasteride

Treatment of Tourette’s Syndrome With Finasteride

PDF: ajp.psychiatryonline.org/cgi/reprint/164/12/1914

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"…The marked male predominance of Tourette’s syndrome suggests that androgens may play a key role in the pathophysiology of this disorder (1).

Accordingly, androgen receptor antagonists, such as flutamide, significantly attenuate Tourette’s syndrome symptoms (2), yet their efficacy is hindered by severe side effects.

A valid alternative to reduce androgen brain signaling may be afforded by inhibitors of 5-alpha-reductase (5-AR), the main rate-limiting enzyme in androgen metabolism. Thus, we tested the efficacy of finasteride, the prototypical 5-AR inhibitor, in a Tourette’s syndrome patient who was unresponsive to traditional therapy. "

"… [b]Finasteride is approved for the treatment of benign prostatic hyperplasia and alopecia; it is psychoactive /b and produces very limited side effects. "

"… In humans, finasteride inhibits mainly the isozyme 5-AR2, the activity of which is potently enhanced by androgens in the adult brain.

Abnormal levels of brain 5-AR2 androgens, such as the potent neuroactive androgen dihydrotestosterone, may contribute to Tourette’s syndrome pathophysiology.

Further studies, including double-blind clinical trials, are needed to fully evaluate the therapeutic potential of finasteride in Tourette’s syndrome. "