‘Never take this drug,’ sales manager at global tech firm wrote in suicide note
April 2, 2025
Dear Friends:
Like Kelsey Libner, Carlos Sarasa González-Aller took finasteride for hair loss. And like Kelsey, Carlos suffered from post-finasteride syndrome.
Like Kelsey, too, Carlos sent his best friend a digital suicide note. And like Kelsey, Carlos made good on that dispatch.
Unlike Kelsey, however, Carlos didn’t go quietly into the night.
Top of the world
On the afternoon of Tuesday, Feb. 4, just 50 days after Kelsey poisoned himself at home in Manhattan, Carlos ascended to the roof of Paseo Castellana 163 in Madrid.
On second thought, roof probably isn’t the best term to describe this location. Luxury perch is more like it: matte granite flooring, overstuffed patio sofas, white marble tables, potted olive trees, and a glass-enclosed conference room overlooking the capital city’s financial district. This is where occupants of the impeccably renovated 12-story office building convene for productive meetings and well-deserved siestas.
Up until last summer, Carlos, a 46-year-old sales manager at global cloud communication firm Sinch, was one such occupant: upbeat, focused, physically fit, and long respected within the tech industry.
In 2001, he earned a business degree from Complutense University of Madrid (CU), one of Europe’s most esteemed public-research institutions, whose graduates include no fewer than seven Nobel Prize recipients.
“Carlos has been collaborating with us on a strategic project we both believe in, which is all about SMS marketing,” fellow CU alumni Alfonso Colmenar wrote a decade ago on LinkedIn. “He’s the ideal partner, anticipating difficulties and turning them into opportunities.”
“He enjoyed great success at work, which had earned him a healthy bank account, with which he supported his hobbies,” Spain’s largest online newspaper, El Confidencial (English), reported.
“He liked to go scuba diving on weekends, and he boasted designer clothing… He was a sportsman. He was a nice person. He didn’t smoke or use recreational drugs.”
Yet eight months ago, with one scribble of an MD’s pen, that idyllic existence was decimated.
Paradise lost
“It’s true he was losing hair, but very little, it was hardly noticeable,” Carlos’s closest friend, and Sinch colleague, Nacho told El Confidencial. “He went to a dermatologist with the idea of getting a transplant, but he was prescribed finasteride because his situation was reversible.
“Shortly after he started taking it, Carlos told me that he wasn’t feeling good, that he had erection problems and couldn’t concentrate. The doctor asked him to stop taking it. It was at that point that everything got worse.”
Over the next seven months, Carlos withdrew from his active social life; no more pub meet-ups with pals, no more fútbol outings, no more scuba diving. Instead, he took to weeping, and staring into space while struggling to maintain his daily exercise routine.
Four months into this descent, in the event of some tragedy, he said, Carlos gave Nacho access to his bank account. Nacho responded by suggesting that his buddy see a psychiatrist. Carlos just couldn’t muster the motivation.
More recently, his transformation from polished go-getter to introverted annoyance became increasingly apparent at Sinch.
“He showed up at the office in a dirty shirt. He was elusive to his companions. He avoided starting conversations. And the few times he did, he was obsessive, always talking about the same subject,” El Confidencial reported.
That subject, of course, was finasteride, which he felt had caused intense insomnia, depression, cognitive dysfunction, and other symptoms he couldn’t shake.
Quittin’ time
So back to Feb. 4, but now the morning of. Nacho arrives at work and is immediately struck by another change in Carlos’s appearance: an open wound on his wrist. Carlos says he fell off his bicycle. Nacho’s concern shifts into overdrive, as he knows Carlos doesn’t own a bike. But he’s also eyeing fellow staffers flocking into the office, and suspects that calling Carlos’s bluff would elicit an awkward scene. He thus remains mum.
When lunchtime rolls around, Nacho strides over to Carlos’s desk for their daily trip to the gym, only to find an empty chair. He calls Carlos’s cell. Carlos says no mood for a workout today, I’m on the roof getting some air. So Nacho heads to the gym alone, then grabs lunch in the same manner. When he returns, a little after 4 p.m., still no Carlos. Nacho scurries back onto the elevator and rides to the top floor.
Carlos is there, though not on the luxury perch, whose outlook is surrounded by a 10-foot glass wall. He’d climbed up to a higher, unprotected point, where the building’s HVAC system sits.
Nacho pleads with Carlos to come down. Carlos refuses. Nacho calls the cops. Carlos leaps.
Though faint, the thud would echo throughout the Kingdom of Spain.
PFS, he wrote
It took El Confidencial more than two weeks to piece together the story of Carlos’s death. But soon after its investigation hit the Internet, TV-news programs rushed to warn the public. In each case, their coverage led with the message Carlos texted to Nacho just before jumping.
“I can’t get out of this dark hole I’ve fallen into. I can’t sleep or focus on anything,” it read. “My life is hell. I took a hair-loss medication that caused my depression. I’ve tried everything to heal myself, but nothing works. It’s called post-finasteride syndrome. Never take it.”
On Antena 3, Spain’s most watched channel, Espejo Público (ESP) (English-subtitled version here) host Susanna Griso fanned out eight pages of side effects reportedly caused by finasteride. Eighty-two in all, they ran the gamut from “abnormally slow heartbeat” to “burning anal pain” to “sensation of pressure in the head” to “vision problems.” And, yes, “suicidal ideation.”
Co-host Miquel Valls, meanwhile, ‘fessed up to finasteride use, and disuse, himself. “I took this medication for months… It wasn’t pills, but injections into my scalp,” he said. “I eventually stopped on my doctor’s advice, because it had several side effects that were affecting my personal life.”
When pressed by Susanna as to the exact side effects he suffered—“Orgasmic disorders? Ejaculatory disorders? Penile shrinkage?”—a blushing Miquel could only say, “This is the first day I’ve felt this uncomfortable on this show.”
The ESP team was joined by Carlos Rerucha, a 31-year-old PFS patient from Madrid who first contacted the PFS Foundation in 2023, to report a battery of symptoms including erectile dysfunction, genital shrinkage, insomnia, anxiety, and, yes, suicidal ideation. That same year, he was twice admitted to a psychiatric ward, to try and stabilize his condition.
In 2024, eager to fight for his own life, as well as the lives of fellow Spaniards in the same leaking boat, he founded the support group Plataforma de Afectados por Finasteride (PAF), which today has more than 150 members.
“The syndrome is a condition where side effects persist after stopping the medication. What doctors claim is that this is a nocebo effect, which is psychological,” he told ESP. “But I can assure you each person’s genetics are different and perhaps not all bodies are prepared for this type of hormonal inhibition.”
Surreal reverberation
Over on competing channel 5 Telecino, the mood was equally intense, with El Programa de Ana Rosa (English-subtitled version here) bannered “MAN JUMPS FROM BUILDING, BLAMING HAIR-LOSS MEDICATION.”
“It is true that there exists a possible link between finasteride use and increased risk of suicidal ideation and depression,” Carmen Fernández-Antón, MD, told host Ana Rosa Quintana. “Epidemiological studies have shown a higher incidence of [these symptoms] in young men.”
Though in the same breath, the dermatologist noted that she can’t speak from experience: “I have hundreds of patients on treatment and have never had anyone affected in this way… it’s very uncommon.”
Says you, said José Enrique de Lucas Bravo, a 48-year-old PFS patient who did not appear on the show. Rather, he found out from the show what had been torturing him for the past 18 years.
In a Hitchcockian twist, José works for Tyco Integrated Security in Madrid. Its services include remote video monitoring. Its clients include Paseo Castellana 163, the building off which Carlos leapt. And its cameras, which are monitored by José, caught Carlos doing so.
“I didn’t see the scene live. I saw it on footage after the incident,” José—whose symptoms include depression, anxiety, chronic fatigue, brain fog, and hypersensitivity to weather—told us.
“Carlos seemed aimless and restless. He spent some time on the building’s terrace talking to a colleague, until he decided to run and jump into an interior courtyard.”
A month later, a Tyco coworker sent José links to the erupting TV coverage of Carlos’s suicide.
“After almost two decades of not knowing what was happening to me—and being seen by equally ignorant doctors—that news made me realize the effects this drug had on my body,” said José, who took finasteride from 2000 to 2018.
Though faint, the thud would echo throughout the Kingdom of Spain.
‘Do-ing vs. undoing
While flashing the question “HAIR-LOSS PILLS THAT ENCOURAGE SUICIDE?” another 5 Telecino program characterized finasteride as “A go-to treatment for many celebrities.”
“John Travolta tried everything to avoid going bald—hair transplants, wigs—all without success. Elon Musk is commonly seen wearing caps to conceal his baldness. And yes, he also uses this drug. Donald Trump does anything to continue showing off his famous blonde hair,” Tarde (English-subtitled version here) reported in its coverage of Carlos’s death.
“But beware because it could have side effects. The hair-loss drug is being reviewed by the European Medicines Agency for inducing suicidal thoughts.”
Despite such news flashes, boldface names continue taking finasteride, some with a devil-may-care attitude.
Just last month, while out promoting his new flick, Bob Trevino Likes It, actor-comedian John Leguizamo told The View, “I’m on Propecia… Propecia for your hair makes your thing not work as much, so then you have to take Viagra to undo the Propecia.”
That, before quipping, “But I want to have good hair. It’s an up-and-down thing.”
Other famous funnymen have fared less well.
According to the coroner’s report in his 2014 suicide case, Mrs. Doubtfire star Robin Williams had been prescribed finasteride.
According to the autopsy report in his 2024 ketamine-overdose case, finasteride was among the medications found at the $8.5 million Los Angeles home of Friends star Matthew Perry.
Finasteride was originally developed by Merck & Co., Inc., and first approved by the US Food and Drug Administration in 1993 as Proscar (5 mg, for enlarged prostate), and again in 1997, as Propecia (1 mg, for hair loss).
In June 2021, Merck spun off its Organon subsidiary as an independent public company (NYSE: OGN). Founded in the Netherlands in 1923, Organon bills itself as a “global health care company dedicated to making a world of difference for women, their families and the communities they care for.”
Among the Merck products Organon acquired in the deal were Proscar and Propecia. To report adverse events for either finasteride product, call the Organon Service Center at (844)674-3200, or email Service_Center@Organon.com.
Anyone living in the US who suffers from PFS should also report his or her symptoms to the US FDA. Anyone living outside the US who suffers from PFS should report his or her symptoms to the US FDA as well as to his or her local DRA, as directed on our Report Your Side Effects page.
If you or a loved one are suffering from PFS, and feeling depressed or unstable, please don’t hesitate to contact the PFS Foundation as soon as possible via our Patient Support hotline: social@pfsfoundation.org
Thank you.