Possible methods to reduce the risk of side effects from finasteride?

[ProscarRules]

What would be the good methods you can try? I read some claims that finasteride 1mg can still work if taken every 3 days. To be as economic as posssible, I am gonna have to go with quartered Proscar or Fincar, but can 1.25mg be taken every 2 days or every 3 days to reduce the chance for side effects and this "initial shedding"? Or can finasteride be taken at smaller than 1mg dose?

I am troubled because doctors that I met with don't even mention the possibility of initial shedding, and they talk as if propecia will work for life if it works whereas it's more realistic for propecia or finasteride to work for about 15 yrs, give or take based on the testimonies from this forum at HairLossTalk.com and other websites.

Now could the reason that doctors don't mention initial shedding and talking as if propecia and/or Rogaine can work for life is because that initial shedding is very rare, and propecia and/or Rogaine will work for life? That would be what my common sense dictiates if I were to have some faith in those doctors....???

I am confused and troubled by contradictions between the doctors I met with and the testimonies on this forum.

 

[Chuck1989]

I hope I'm not hijacking this thread by adding my own dilemma to it:

I'm also interested in an answer to this. I recently started losing my hair and am keen to nip it in the bud before it's too late. Based on the research I've done it looks like finasteride. is the only proven method that works, and any and all success stories have finasteride. as a baseline and extra topical products as extras to this.

Reading the wiki however, I'm seeing a lot of statistics about finasteride's link with depression. I suffer from severe depression (the hairloss isn't helping to be honest!) and suicidal tendencies, which I fend off with a combination of activity and music. The wiki reports of side effects including impotency and increased risk of depression - tbh I care less about the impotency; I'm obviously not getting any after I go bald! - but there's a mention that finasteride. irreversably restricts the ability to experience euphoria, which I kind of rely on music to induce. So potentially I'm faced with a tough decision - bring back my hair to fend off male pattern baldness-related depression, but at the cost of the only thing I'm still living for!

I guess my question is, any artistic types or otherwise notice any shift in mood/temperament/emotional highs and lows as a result of taking finasteride? Statistics are all well and good, but I wanna hear from some personal experience before I make such a significantly life-altering decision.

 

[Wuffer]

Reading the wiki however, I'm seeing a lot of statistics about finasteride's link with depression. I suffer from severe depression (the hairloss isn't helping to be honest!) and suicidal tendencies, which I fend off with a combination of activity and music. The wiki reports of side effects including impotency and increased risk of depression

The depression studies listed in Wikipedia aren't exactly conclusive. The first one was circumstantial in that the patients reported these symptoms while they were on finasteride, but the symptoms could be unrelated, a result of the nocebo effect, and so on. The second study enrolled 100-something people and compared depression/anxiety results before and after. However, without a placebo control, the results aren't that strong. The reason I say this is when finasteride is tested in a placebo controlled environment, depression and anxiety are never reported. The third study is particularly poor in that the participants consisted of individuals who have persisting sexual dysfunction. Of course they will be depressed, anxious and have suicidal tendencies.

irreversably restricts the ability to experience euphoria, which I kind of rely on music to induce. So potentially I'm faced with a tough decision - bring back my hair to fend off male pattern baldness-related depression, but at the cost of the only thing I'm still living for!

Where did you read this? It's pretty hard for me to believe a drug could permanently inhibit the ability for a person to feel pleasure!

I guess my question is, any artistic types or otherwise notice any shift in mood/temperament/emotional highs and lows as a result of taking finasteride? Statistics are all well and good, but I wanna hear from some personal experience before I make such a significantly life-altering decision.

I am a fairly artistic type. I play classical guitar and write some of my own music, and I also produce trance music. I've been on finasteride and I have had absolutely no change in my emotional highs/lows, my ability to be creative or the ability to feel pleasure. I went through severe depression and anxiety in my early 20's (I am 30 now), so I would consider myself a risk for recurrence, but haven't had any issues whatsoever.

I'm not trying to convince you one way or another, but based on the research I've seen, there isn't that much proof that finasteride causes depression. As per the first study mentioned in Wikipedia, depression went away in all patients that discontinued the medication.

 

[Fanjeera]

http://en.wikipedia.org/wiki/Allopregnanolone
This. And it certainly is not only produced by 5ar1. Probably both of them. But there are many more GABAa regulators that calm our minds down (ethanol for example), so if you're nervous already, you probably don't need it that much anyway.

 

[Chuck1989]

Wuffer,

Thank you for such a detailed response. Apologies for being late to reply - work has gotten in the way of everything these passed few weeks.

Where did you read this? It's pretty hard for me to believe a drug could permanently inhibit the ability for a person to feel pleasure!


This too was Wikipedia:
"Cause of mood-related and sexual side effects
DHT, and neuroactive steroids (NAs) such as allopregnanolone (ALLO) and tetrahydrodeoxycorticosterone (THDOC), potent positive allosteric modulators of the GABA[SUB]A[/SUB] receptor—which is the same site of action of euphoriant and anxiolytic drugs like benzodiazepines and alcohol), are important endogenous neuroregulators that have been shown to possess powerful antidepressant and anxiolytic effects as well as to play a positive role in sexual function.[SUP][26][/SUP][SUP][25][/SUP][SUP][41][/SUP] Their biosynthesis is dependent on both isoforms of 5α-reductase, and accordingly, finasteride has been shown to reduce their formation in the body.[SUP][42][/SUP][SUP][43][/SUP][SUP][44][/SUP] As such, this effect of finasteride is a likely cause of the emotional and sexual side effects associated with the drug.[SUP][25][/SUP][SUP][26][/SUP]"

That, combined with the conclusion from the below study:

"In August 2012, a study of 61 former users of finasteride with persistent sexual side effects found that 75% of them showed significantly higher rates of depressive symptoms relative to a control group. Of the treated men, 11% had mild symptoms, 28% had moderate symptoms, and 36% had severe symptoms. In addition, 44% of these men reported suicidal ideation. In the control group of 29 men, 10% showed depressive symptoms, with all of these cases being mild, and 3% reported thoughts of suicide. It was concluded that finasteride may cause symptoms of depression and suicidal ideation which can persist even after discontinuation of treatment.[29][30]"

I am a fairly artistic type. I play classical guitar and write some of my own music, and I also produce trance music. I've been on finasteride and I have had absolutely no change in my emotional highs/lows, my ability to be creative or the ability to feel pleasure. I went through severe depression and anxiety in my early 20's (I am 30 now), so I would consider myself a risk for recurrence, but haven't had any issues whatsoever.

Naturally this is exactly the kind of response I was hoping to receive. If I could theoretically take on this treatment long term without any [serious] side effects then obviously that would be ideal. And as you mention depression and anxiety in your early 20s not reoccuring that is somewhat encouraging. But can I ask how long you've been on Finasteride, and what your daily dosage is?

Thanks again.

 

[Quantum Cat]

I doubt missing a dose a day or two per week would have much negative impact on suppressing DHT, but might help reduce side effects.

also don't believe anything you read on Wikipedia. The scaremongerers edit it to list all the terrible side effects like permanent impotence when there is no evidence of that. the articles don't give a balanced, proven view; just wild speculation by non-experts. Even if they mean well, their sources are highly dubious, taken from media stories or unscrupulous lawyers.

 

[RebelHair]

I have been a user of finasteride for 2 years and let me tell you, The side-effects are Very Real !

I find that women dont actually mind whether a guy has hair or not.
Similar to you i suffered from Fn induced depression, As a result i had a lower quality of life,
Lost many contacts, Ended up clinging to a manipulative girlfriend.
Basically i wasted those years of my life....

My erections were regimented, I couldnt find the will or the strength to engage in sex
for more than once a day. Also i had very watery semen of low quantity.
Its been a year since im off it, and i cannot sustain erections as long as i used to before taking the pills.
But i can notice huge changes in this department.

So id suggest you start living your life to the fullest and not worry too much about losing your hair.

Id recommend you use only topical solutions, which dont mess up your body,
You can always do a hair transplant once things are right

I hope I'm not hijacking this thread by adding my own dilemma to it:

I'm also interested in an answer to this. I recently started losing my hair and am keen to nip it in the bud before it's too late. Based on the research I've done it looks like finasteride. is the only proven method that works, and any and all success stories have finasteride. as a baseline and extra topical products as extras to this.

Reading the wiki however, I'm seeing a lot of statistics about finasteride's link with depression. I suffer from severe depression (the hairloss isn't helping to be honest!) and suicidal tendencies, which I fend off with a combination of activity and music. The wiki reports of side effects including impotency and increased risk of depression - tbh I care less about the impotency; I'm obviously not getting any after I go bald! - but there's a mention that finasteride. irreversably restricts the ability to experience euphoria, which I kind of rely on music to induce. So potentially I'm faced with a tough decision - bring back my hair to fend off male pattern baldness-related depression, but at the cost of the only thing I'm still living for!

I guess my question is, any artistic types or otherwise notice any shift in mood/temperament/emotional highs and lows as a result of taking finasteride? Statistics are all well and good, but I wanna hear from some personal experience before I make such a significantly life-altering decision.

 

[Chuck1989]

I doubt missing a dose a day or two per week would have much negative impact on suppressing DHT, but might help reduce side effects.

also don't believe anything you read on Wikipedia. The scaremongerers edit it to list all the terrible side effects like permanent impotence when there is no evidence of that. the articles don't give a balanced, proven view; just wild speculation by non-experts. Even if they mean well, their sources are highly dubious, taken from media stories or unscrupulous lawyers.

Have to be honest, I'm not convinced. I hear a lot of the "everything on wikipedia is lies" argument but ultimately it's about as supportable as the content it's trying to criticize (if not less). I'm not saying scaremongering doesn't happen, I'm just entertaining the notion that there could be a genuine conflict of opinion here, hence trying to gauge some kind of ratio of positive/negative experiences. Even if wikipedia was the tangled web of lies some folks make it out to be, there are a considerable number of contributors on this forum alone describing some pretty horrific side-effects resulting from propecia; are these all scaremongerers and conspiracy-theorists too? Adding an alien chemical to my diet is something I'm always going to be careful of,and I want to be well-informed of its effects. The medical institutions and regulators don't have a 100% squeeky clean record for getting it right, and this is still a relatively new drug, hence my concerns. It's possible there could be zero credence whatever to the recent studies linking finasteride to prostate cancer for example, but without any qualifiable certainty either way, would I want to risk it?

I'd be interested in hearing more accounts of people who've been on this drug but experienced few or insignificant sides. Their daily intake, maybe some info about their medical/mental health background. It may be safe to assume that the people experiencing serious side effects are the ones screaming about it the most, but is this a minority, or a sizeable proportion of users? This drug will inevitably effect different people in different ways, so having a wider sample to base this on would give me a clearer idea of my odds of being one of the "at risk" category.

Thanks again.

- - - Updated - - -

I have been a user of finasteride for 2 years and let me tell you, The side-effects are Very Real !

I find that women dont actually mind whether a guy has hair or not.
Similar to you i suffered from Fn induced depression, As a result i had a lower quality of life,
Lost many contacts, Ended up clinging to a manipulative girlfriend.
Basically i wasted those years of my life....

My erections were regimented, I couldnt find the will or the strength to engage in sex
for more than once a day. Also i had very watery semen of low quantity.
Its been a year since im off it, and i cannot sustain erections as long as i used to before taking the pills.
But i can notice huge changes in this department.

So id suggest you start living your life to the fullest and not worry too much about losing your hair.

Id recommend you use only topical solutions, which dont mess up your body,
You can always do a hair transplant once things are right

This is a great post, thank you. And I genuinely feel for you in your predicament, and hope that your situation continues to improve. What you describe is exactly the kind of situation I am trying to avoid, so I'm grateful for your input.

 

[Quantum Cat]

I'd be interested in hearing more accounts of people who've been on this drug but experienced few or insignificant sides.

you'll rarely hear accounts like that on this forum - what you read in these forums is NOT the majority of men's experiences. People are far more likely to come here with their horror stories both to vent and try to get help. It's not at all representative of all the men who take finasteride.

When it comes to a controversial and complex subject like this, in my book you can never trust wikipedia, or even half of what you read on these forums

 

[Wuffer]

"Cause of mood-related and sexual side effects
DHT, and neuroactive steroids (NAs) such as allopregnanolone (ALLO) and tetrahydrodeoxycorticosterone (THDOC), potent positive allosteric modulators of the GABA[SUB]A[/SUB] receptor—which is the same site of action of euphoriant and anxiolytic drugs like benzodiazepines and alcohol), are important endogenous neuroregulators that have been shown to possess powerful antidepressant and anxiolytic effects as well as to play a positive role in sexual function.[SUP][26][/SUP][SUP][25][/SUP][SUP][41][/SUP] Their biosynthesis is dependent on both isoforms of 5α-reductase, and accordingly, finasteride has been shown to reduce their formation in the body.[SUP][42][/SUP][SUP][43][/SUP][SUP][44][/SUP] As such, this effect of finasteride is a likely cause of the emotional and sexual side effects associated with the drug.[SUP][25][/SUP][SUP][26][/SUP]"

Honestly a lot of this is over my head, and I don't understand half of it. However, this seems to be more of an educated theory based on the author's interpretation rather than established fact. It's basically saying finasteride may inhibit steroids that may be responsible for sexual functioning & maintaining mood. However, since we don't know exactly how much finasteride inhibits them, or how critical they are for maintaining mood and/or sexual function, it's difficult to reach a firm conclusion. But I would actually agree with the author that in a small number of people, this would be a good explanation for why side effects happen.

"In August 2012, a study of 61 former users of finasteride with persistent sexual side effects found that 75% of them showed significantly higher rates of depressive symptoms relative to a control group. Of the treated men, 11% had mild symptoms, 28% had moderate symptoms, and 36% had severe symptoms. In addition, 44% of these men reported suicidal ideation. In the control group of 29 men, 10% showed depressive symptoms, with all of these cases being mild, and 3% reported thoughts of suicide. It was concluded that finasteride may cause symptoms of depression and suicidal ideation which can persist even after discontinuation of treatment.[29][30]"

This one I do understand, and it is the third of an extremely poor set of studies done by a Dr. Irwig. I won't go into details why this is almost complete garbage, but trust me

Naturally this is exactly the kind of response I was hoping to receive. If I could theoretically take on this treatment long term without any [serious] side effects then obviously that would be ideal. And as you mention depression and anxiety in your early 20s not reoccuring that is somewhat encouraging. But can I ask how long you've been on Finasteride, and what your daily dosage is?

I'm of the mind that side effects are rare, and serious, long-term side effects are extremely rare. But understand you are taking on some level of risk with any prescription medication.. But then again, you probably do a dozen riskier things on a daily basis!

I have been on finasteride for 2 years now, on 1.25mg per day. I obtained some good growth fairly quickly, and held my results with no signs of slowing down. Comparing pictures, my hair is about where it was 4 or 5 years ago. I've been extremely lucky with the medication, so I would recommend giving it a go.

- - - Updated - - -

Wikipedia is generally a good resource for information on most topics, but you should always check the sources when you see something that doesn't seem quite right. There is no question that people wanting to push their viewpoints about finasteride have been doing so on wikipedia; just look at the talk page for that article. Especially with articles on medicine, it can be a free-for-all. There is just to much content for some of the authors trained in medicine to look through all the sources and ensure everything is accurate.

People who have had a bad experience with the drug are generally extremely vocal, and I've seen countless cases where people have been posting under multiple user accounts on forums (even on Wikipedia). I honestly think what seems like a widespread issue is actually quite limited. Even though there are over 2000 members on Propeciahelp, the forum is relatively dead, and there only seems to be a few dozen active posters. I saw there was a petition to withdrawal Propecia from the market and it only has around 100 signatures. With how widespread this issue seems, I would have expected thousands of signatures.

That's just my take on it anyhow.. Keep in mind also on forums, you are probably only hearing from less than 1% of people who take the stuff, and even then, mostly only from the people with a negative experience.

 

[Quantum Cat]

Dr. Earwig is a charlatan who should be stripped of his titles.

the Propeciahelp.com people are bitter and spiteful. They want Finasteride outlawed which would spell misery for the many thousands of men who get benefit from it, dooming us all to baldness. Reprehensible :shakehead:

 

[wstef]

If people get side effects - which are usually sexual or aesthetic - then of course this will make people more depressed.

However, I think the claims that just 2% of people will get side effects. I imagine it is more only people deal with them.

Wikipedia is bollocks anyway. It's a good starting point for a lot of research but where money is to be made or a point to be proven the articles are often bias with dubious sources. I like it to learn about new things but take it with a pinch of salt.

So... anyone got and advice on reducing the sides like the OP asked originally? I'd be interested to know as well because I am having one persistent one which has caused me to stop taking Propecia.