Concerned about finasteride...side effects
I've been using finasteride (proscar cut into roughtly 1.25mg quarters) now for about four to five months. I can't tell yet if it is helping my hair, which is not suprising given this short duration.
I have experienced few if any sexual side effects, except that maybe I'm not as consistently horny as I used to be. That isn't entirely a bad thing. However, despite the intact sex life, I must admit I've felt a bit more moody on it than I used to feel. I thought maybe it was just my imagination, but then one night I went to a party and had a couple beers. I don't drink very often and my tolerance is not all that high these days. I was suprised to notice that I didn't really feel drunk. I had two more beers. At this point I should have had a lampshade on my head, but instead I felt only slightly buzzed. Another night I went out to eat with my girlfriend and, after a couple drinks, felt next to nothing. At least, I didn't feel that kind of relaxing high that alcohol can give you. All I felt was a bit red in the face.
I didn't think much of it at the time, but on a hunch, I got on the internet, wondering if finasteride might affect the way EtOH is metabolized or something.
Much to my suprise, I did find a connection between finasteride and alcohol. It would appear that alchohol causes an increase in the production of a "neurosteroid" called allopregnanolone. Allopregnanolone binds to a certain receptor in your brain, the GABA(A) receptor. GABA(A) is a receptor for a neurotransmitter called GABA (short for gamma aminobutyric acid). GABA is one of the major inhibitory neurotransmitters, and is implicated in many anxiety disorders and depression. Certain anti-anxiety drugs like valium bind to GABA's recpetor too. Allopregnanolone is an "allosteric enhancer" of the GABA(A) receptor. That means it helps the receptor do it's job better. Specifically, it intensifies the effects of GABA by making it much easier for GABA to "turn on" the receptor. So, when you drink alcohol, more allopregnanolone gets produced, GABA is thus made more potent, and you feel relaxed and happy.
Here's the deal: Allopregnanolone is a metabolite of progesterone. Guess what is one of the enzymes responsible for converting progesterone to allopregnanolone: Yep, 5-alpha reductase. In other words, just like it inhibits the conversion of testosterone to DHT, finasteride blocks the conversion of progesterone to allopregnanolone.
It gets worse: Just before menstruation, the levels of progesterone in a woman's body drop dramatically. This leads to a corresponding drop in allopregnanolone, which leads to...PMS! That's right, one of the reasons women get moody and anxious before they get their period is because they're experienceing allopregnanolone withdrawl. Contrary to what many think, men also make progesterone, and men also depend on allopregnanolone for the proper functioning of GABA in their brains.
Needless to say, I have been doing a lot of reading about this, and I'm a bit alarmed. I knew going into it that finasteride could maybe effect erections or my sex drive, but nobody said it could make me depressed or anxious too. But there is clear scientific evidence out there that finasteride can have some profound effects on the way your brain works. Most specifically, it will effect the way your brain reacts to stress: stress causes increases in the production of allopregnanolone, and allopregnanolone production in the cerebral cortex is greatly inhibited by finasteride. Some people are even considering giving finasteride to alcoholics to help them get off the sauce: Since finasteride deprives you of the relaxing reward of drinking, there's less of an incentive to drink!
I work as a biologist. The studies on this subject have been published in some very reputable journals, like The Proceedings of the National Academy of Sciences, The Journal of Neuroscience, Brain Research, etc.
Just follow this link:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
Type in the blank "finasteride" and "allopregnanolone" and see what you turn up. Scientists use finasteride as a tool in the lab to study behavior in rats, like their response to alcohol or stress. Loss of allopregnanolone even makes rats more prone to seizures when treated with certain drugs. I'm not making any of this up.
My feelings upon reading all this stuff: Oh f**k! I really don't know what I should do at this point. My emotional state has only been mildly affected, I would say, and I can't really say I've experienced any significant impact on my life. But the fact is, this drug does more than just just stop you from losing your hair (maybe). It turns out there are a lot of steroid hormones in your body, and many of them are converted by 5-alpha reductase. All of these hormones have a purpose, and I just have to wonder what the long-term effects of monkeying around with them might be. If all finasteride did was inhibit DHT, I probably could ignore it, since my sex life is fine. But I'm not so sure any of us should ignore some of its other effects. We should at least be fully informed as to what this drug does to our bodies.
So, what do you all think?
