i dont have anything solid to back this claim up but i would venture a guess that if both were taken independently of one another, finasteride would be better simply because it directly lowers your DHT and because it's a long term solution. you can't stay on 200mg spironolactone long term unless you want to pretty much be a menopausal woman. i know that might defeat the purpose of the question but it's a big factor. besides, in what situation would you be taking 200mg spironolactone but not be able to also take finasteride? i'd assume at that point sides are a non-factor anyway