Switching to dutasteride

[Rutt]

Hey all

I *really* want to switch from 1mg finasteride to either 0.5 or 2.5mg dutasteride

all the studies i've seen show that dutasteride 2.5mg is statistically significantly better than 0.5mg (and especially finasteride at any level). however 0.5mg is already decently expensive (~500$/year but so worth it). Is 2.5mg gonna be 5x as much?

also, i mean dutasteride works so well, why is everyone not on it? sides?

i hope not b/c it's hard to get from doctors, b/c i'm really hoping to get my script swapped

 

[Rutt]

i've heard stories that people have gone permenantly impotant on avodart and maybe finasteride.

is that actually true or just a rumor?

 

[Todd]

There are a few cases of persistent erictile dysfunction and/or lack of libido in the case of finasteride.
This is estimated to be less than 1%, though, and in the 2% that get side effects, the side effects disappears within a few weeks when you quit finasteride.

 

[All_The_Above]

I have experienced zero side effects on Dutasteride. In fact I feel much hornier on Dutasteride than when I was on Finasteride. Of course, everyone is different. It seems that people who have negative side effects tend to post more on these forums and so you get a distorted perspective about how dangerous these drugs are. You can get Dutasteride fairly cheap from inhousepharmacy.

 

[Todd]

Thing is: finasteride and dutasteride doesn't REMOVE DHT (and all of the other metabolites of alpha reductase; such as the other neuroactive ones besides DHT), it LOWERS the levels and ALTERS the balance. (DHT down, testosterone and estrogen up i.e)
DHT isn't removed, just lowered, but the remaining DHT will still work in your system and do what it's supposed to do.

Most people with stable endocrine and neuroendocrine levels can handle a little lowering and altering just fine (the numbers change, but they're still within the normal range). The system takes a hit, but it still functions as if nothing really happened.
(cognition and mood is fine, libido is fine, fertility is fine, hair is great)


But for some people, this altering is what sets the entire system off balance, and so instead of just mild, passing side effects, the side effects gets particularly nasty, or even persistent long after they quit the drug.

So if you're worried, get your bloodwork done before you start treatment.

 

[Todd]

Dutasteride inhibits about 90%+ of DHT, and Finasteride inhibits between 60%-70% I would say that's more than a little bit of suppression....

In case of dutasteride, it's a lot.

In the early trials and clinical experience with proscar (this have had to be in the seventies) it was presumed by some researchers and doctors that impotence, lack of libido and not to mention INFERTILITY not only was possible SIDE effects, but would in fact be ADDITIONAL effects to shrinking the prostate.

The results turned out to be quite unexpected: only 2-4% suffered from side effects, the most common being lack of libido. Fertility seemed to be unaffected, and impotence was rarer than loss of libido. Another unusual finding was that prostate size shrinked allright, but not SO MUCH as one would expect.

This suggested several things: first of all, that prostate growth is affected by other substances than DHT (IGF, for instance, as researchers later figured out)
AND (most importantly):
*That testosterone BY ITSELF can stimulate the androgen receptor WITHOUT being reduced by alpha reductase
*That testosterone (and not DHT) play a greater role in libido and fertility than first thought
*That DHT in many men is produced "in excess"- we apparently have more than we use- or to put it more correctly: ALPHA REDUCTASE ENZYMES are present in excess in various tissues (not just skin and prostate), locally converting testosterone to DHT, and that this excess presence is contributing to BPH, prostate cancer and (surprise, surprise) BALDNESS in susceptible men.

This is why finasteride has an evident ANDROGEN INHIBITING- effect, and NOT an ANTI ANDROGEN- effect.

Of course later research have discovered that there's a reason for "excess" alpha reductase enzymes: bone growth and neuroendocrine function being two important factors. I'm sure more is to be discovered in the future.
Still; every piece of evidence suggest that FOR MOST MEN (though not all) finasteride is safe, and apparently safe for long time use.
Dutasteride hasn't been around for that long, but strangely enough, even though it inhibits both alpha reductase inhibitors, and decreases DHT by a heck of a lot more (90% vs 65%) IT STILL DOESN'T PRODUCE MORE SIDE EFFECTS.
It's weird, but those are the data.

 

[Todd]

Hmm. Could've sworn finasteride patent was older than 1992. I thought the first papers on ARI were written in the late seventies...

With regards to the neuroactive function: you are absolutely right; and although most of this research is pretty new yet, it's great to finally know why some people get depressed while on finasteride. These studies also implicate that depression can be treated on an endocrine level (maybe by increasing alpha reductase metabolites?). Quite exiting.

But isn't it weird how many guys DON'T become depressed?

 

[Bryan]

Hmm. Could've sworn finasteride patent was older than 1992. I thought the first papers on ARI were written in the late seventies...

What do you mean by "ARI"?

 

[Rutt]

Of course people who take finasteride are more likely to be depressed. Just like people who take accutane are more likely to be depressed. Just like short people are more likely to be depressed.

They're considered unattractive by society, that's the reason they're depressed, not the drugs.