Accordingly, Health Canada and the UAE Ministry of Health recommend that companies that produce products containing [finasteride] add the above-mentioned warning to the internal leaflet of their products. Hi Karl, Id do an organic acid test and a DUTCH test to see what specifically addressing. You must know that this molecule, finasteride, has been the subject of more than 2,600 scientific articles found in trustworthy databases. Statement (via Twitter) in response to a study titled Investigation of Suicidality and Psychological Adverse Events in Patients Treated With Finasteride, December 7, 2020. Letter to the PFS Foundation, March 2, 2022. PFS can start shortly after starting the medication and can possibly last months to years after stopping. They have muted orgasms, reduced volume of ejaculate, reduced penile sensation If it is 1.4 percent [of finasteride patients who experience persistent sexual dysfunction] and there are several million people on this product, youre looking at 300,000 men rendered impotent by a hair-loss drug. If you are unable to import citations, please contact Propecia should have never been approved, and its authorization should be revoked as soon as possible. Hi, no I dont have insomnia. Over time, it has been considered a safe and well-tolerated drug with rare and reversible side effects. A second 5-reductase inhibitor, dutasteride, was approved in 2001 for benign prostatic hyperplasia. Finasteride: NOT a benign drug. Long-term-treatment follow-up revealed that (5 mg/day) effects on hair growth are sustained in most women. I think we need to put the [PCPT] trial concerns to rest. I didnt believe it either, until 10 years ago, when I started seeing more men with PFS I advise you once again to never use [finasteride] to treat hair loss. Ipamorelin vs HGH: the biggest downside is, MK-677 and erectile dysfunction: how to use it correctly, Pre-workout induced ED? Post-Finasteride Syndrome: Efforts to explain persistent symptoms are undermined by poor long term data on harms: The BMJ, August 9, 2019. Some have petitioned the FDA to include post-finasteride syndrome as a boxed warning. This is the most serious warning given about a medication. Alteration of Gut Microbes in Benign Prostatic Hyperplasia Model and Finasteride Treatment Model. We aimed to determine the type and frequency of symptoms in men having long-term sexual and non-sexual side effects after finasteride treatment (a condition recently called post-finasteride syndrome, PFS) against androgenetic alopecia (AGA). I think [Propecia] is a potentially dangerous drug. Winston-Salem, NC, Ross J. Baldessarini, MD, Professor of Psychiatry, Quoc-Dien Trinh, MD, Associate Professor of Surgery, Wexner Medical Center, Ohio State University, Govinda Healthcare Medicentre, New Delhi, India, Associate Professor of Urology University of Arizona, University of Miami Miller School of Medicine, Omer Onur Cakir, MD, Department of Urology, Bagcilar Training and Research Hospital, Istanbul, Turkey, Pelita Harapan University Faculty of Medicine, Tangerang, Indonesia, Shelly Gray, PharmD, Shirley & Herb Bridge Endowed Professor, University of Washington School of Pharmacy, YOU & WEE Urologic Surgery & Wellness, Sarasota, FL, Faysal A. Yafi, MD, Associate Professor of Urology, University of California, Irvine Medical Center, Naeem Bhojani, MD, Associate Professor of Urology, Andrology Fellow, Northwestern University, Wedad Saeed Al-Qahtani, Assistant Professor, Naif Arab University for Security Sciences, Riyadh, Saudi Arabia, Abdulmaged M. Traish, PhD, Professor of Biochemistry and Urology, Mark A. Moyad, MD, Director of Preventive & Alternative Medicine, University of Michigan Department of Urology, Abdulilah Al Malik, Regulatory Affairs Director, Saudi Arabia, The Psychiatric Institute, University of Illinois at Chicago, Douglas G. Adler, MD, Professor of Medicine, Medical Director, Sperling Prostate Center, Serrate & Ribal Institute of Urology, Barcelona, Roberto Melcangi, PhD, Head of Neuroendocrinology, Department of Pharmacological and Biomolecular Sciences, Silvia Diviccaro, PhD, Post-Doctoral Fellow, Department of Pharmacological and Biomolecular Sciences, Irwin Goldstein, MD, Clinical Professor of Surgery, University of California at San Diego, Editor-in-Chief, The Journal of Sexual Medicine, Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, Krohnstiegcenter Dermatology Center, Hamburg, Germany, Glickman Urological and Kidney Institute, Cleveland Clinic, Hospitalist, UAB Medicine, Birmingham, AL, Andrea Militello, MD, Urologist/Andrologist, Department of Urological, Biomedical and Translational Sciences, Federiciana University, Michael Zitzmann, MD, Andrology Professor, Michael Carmone, MD, Director, Health Research Group, Dietrich von Herrath, MD, Chief Physician, Steven M. Belknap, MD, Research Assistant Professor of Dermatology and Medicine, Northwestern University Feinberg School of Medicine, Marcel Waldinger (1955-2019), MD, PhD, Professor, Department of Pharmacology, Shalendar Bhasin, MD, Professor of Medicine, Alex Tatem, MD, Fellow in Andrology, Male Fertility and Microsurgery, Department of Urology, NYU Grossman School of Medicine, Franois Desgrandchamps, MD, PhD, Chief of Urology, Bernard Bgaud, MD, Professor of Pharmacology, Carla Di Loreto, PhD, Experimental and Clinical Medical Sciences, Nelson Novick, MD, Clinical Professor of Dermatology, Charles J. Ryan, MD, Distinguished Professor of Clinical Medicine and Urology, Jan Tytgat, PhD, Professor of Toxicology and Pharmacology, Erika Cecchin, PhD, Researcher in Clinical and Experimental Pharmacology, Donatella Caruso, PhD, Professor of Pharmacology and Biology, Ralph M Treb, MD, Proefssor of Dermatology, Center for Dermatology and Hair Diseases, Zrich, Sabina Cauci, PhD, Medical and Biological Sciences, Christine A Ganzer, PhD, Assistant Professor, Silvia Giatti, PhD, Pharmacological and Biomolecular Sciences, Bruhin & Associates Psychotherapists, San Diego, California, Professor of Urology, Feinberg School of Medicine, Carlo Trombetta, MD, Head of Department of Urology, Dirk Michielsen, MD, Professor of Urology. Side effects thought to be caused by post-finasteride syndrome can be mild or serious. The authors declare no conflicts of interest. If prolactin is high, dopamine is most likely low and serotonin elevated, so then it would be good to focus on lowering prolactin. If I work out too much or my job is extra stressful I become symptomatic. Yes, in general its safer with less sides, but some people have reported similar side effects as fin. Indian J Plast Surg. Statement (via Twitter) in response to Jagan Kansal, MDs tweet, Thoughts on propecia in young guys causing decreased libido, possibly permanent? November 13, 2020. As prescribers, our primary duty is to do no harm. The Virility Paradox: The Vast Influence of Testosterone on Our Bodies, Minds, and the World We Live In: February 2018. HTX Urology website, December 2019. A Pill the Doctor Gave Me Destroyed My Life (English translation): Die Zeit, Feb. 22, 2018. Do you have any digestive issues? Normal T and gonadotropins on lab evaluation. Hi man, Id use pregnenolone and D-phenylalanine to counter the long term sides. The use of Finasteride (Proscar) for the prevention of cancer is limited since it only prevents the harmless type of prostate cancer (the SKY Stage.) Direct Healthcare Professional Communication letter, October 4, 2018. HCG will most likely increase progesterone, but hopefully, it can stimulate 5AR which will increase allopregnanolone. Taking Propecia or Proscar to Prevent Hair Loss is Associated with Depression, Anxiety, and Sexual Problems: National Center for Health Research website, 2021. Disclaimer. I want to try HCG 50 UI per day. Insomnia and fatigue/tiredness were some of the most debilitating symptoms Men under 40 years of age who use finasteride for alopecia are at risk of suicide if they develop persistent sexual adverse effects and insomnia. I have hundreds of [PFS] patients. Will start vitamin K soon. Thanks for citing our work [Dr. Faysal]. Just wanna ask advice from a casual weed smoker as in vaping on weekends what would be a good supplement/nutritional addition to counter any negative effects? Thus, it is inappropriate to dismiss this condition. This is the first analysis, to our knowledge, of suicidality and psychological adverse events in association with finasteride in VigiBase, an international pharmacovigilance databaseThese findings could raise concern that younger men with alopecia may be especially at risk for suicidality compared with the general populationClinicians should pay greater attention to the psychological adverse effects of finasteride when prescribing them, especially in the younger population using the drug for hair loss. The Top 20 Hair Loss Studies of 2020: Donovan Medical (YouTube), December 11, 2020. We believe the warnings about finasteride are justified. Based on currently available data, the use of 5-reductase inhibitors in patients with a history of depression, sexual dysfunction or infertility must be carefully and individually evaluated. Based on the existing body of evidence in the contemporary clinical literature, the author believes that finasteride and dutasteride induce a constellation of persistent sexual, neurological and physical adverse side effects, in a subset of men. How much Glycin and Niacinamid do you recommend? Depression and suicidal behavior are all very serious side effects caused by finasteride, and this is absolutely unacceptable for a lifestyle drug Rationally, one cannot advocate for this medicine or justify the fact its still on the market. In a key investigation undertaken at Baylor College of Medicine under Dr Mohit Khera, Howell et al. Rzeszotek S, Kolasa A, Pilutin A, Misiakiewicz-Has K, Sielatycka K, Wiszniewska B. Biomedicines. Hi Gary, Who would have thought trying to enhance the hairline would cause bigger problems! A growing number of doctors, researchers and therapists have in recent years been voicing their concerns about finasterides potential to cause persistent physical and mental side effects, known as post-finasteride syndrome (PFS), in a subset of patients. Medications Most Commonly Associated With Erectile Dysfunction: Evaluation of the Food and Drug Administration National Pharmacovigilance Database. Statement via Twitter, February 10, 2022. Finasteride (Proscar, Avodart, dutasteride) is absolute garbage on a serious note! Sure I can do that for you. 200 mg of pregnenalone per day. Expanding (via Twitter) on a study published in JAMA Dermatology he co-authored, titled Investigation of Suicidality and Psychological Adverse Events in Patients Treated With Finasteride, December 7, 2020. Blocking 5 alpha-reductase to any degree in the brain is a crapshoot. And thats huge. Ruksiriwanich W, Linsaenkart P, Khantham C, Muangsanguan A, Sringarm K, Jantrawut P, Prom-U-Thai C, Jamjod S, Yamuangmorn S, Arjin C, Rachtanapun P, Jantanasakulwong K, Phimolsiripol Y, Barba FJ, Sommano SR, Chutoprapat R, Boonpisuttinant K. Plants (Basel). Hi David, Statement (via Twitter) in response to Jagan Kansal, MDs tweet, Thoughts on propecia in young guys causing decreased libido, possibly permanent? What Was the Cause? Do tests to see pregnenolone, progesterone, testosterone, DHT, thyroid (TSH, total and free T4 and T3, rT3), estradiol, estrone-sulfate and cortisol (both blood and 24h saliva). Clipboard, Search History, and several other advanced features are temporarily unavailable. These drugs are poison. Accessibility Find support. However, it can affect general appearance. In 2017, the European Medical Agency recommended adding warnings of potential risk of suicidal ideation to product information for finasteride. Are Hair-Loss Drugs Safe? We stopped prescribing finasteride because the risk is just too high. The https:// ensures that you are connecting to the Finasteride is a 5-alpha reductase inhibitor that's used to treat androgenetic alopecia (a clinical term for male pattern baldness) and benign prostatic hyperplasia (non-cancerous growth of the prostate gland). The Interplay between Finasteride-Induced Androgen Imbalance, Endoplasmic Reticulum Stress, Oxidative Stress, and Liver Disorders in Paternal and Filial Generation. HHS Vulnerability Disclosure, Help Hi man, what have you done so far that helped you to 80% recovery? Kaplan-Marans E, Sandozi A, Martinez M, Lee J, Schulman A, Khurgin J. Post-finasteride syndrome (PFS) is a constellation of serious adverse side effects manifested in clinical symptoms that develop and persist in patients during and/or after discontinuing finasteride treatment in men with pattern hair loss (androgenetic alopecia) or benign prostatic hyperplasia. Aging Male. The effect of finasteride on dry eye disease, Investigative Ophthalmology & Visual Science: June 2022. The aim of this study was to explore how having a preexisting personal and/or familial history of a psychiatric diagnosis and certain personality traits may influence anxiety and depression . A Pill the Doctor Gave Me Destroyed My Life. Chiriac G, Cauci S, Mazzon G, Trombetta C. Andrology. Agreed. Now two months after stopping Dudasteride, my twitches and brain zaps are now greatly diminshed, insomnia is still a problem though. An official website of the United States government. Before Since some of the effects of androgen inhibition cannot be reversed once local androgen levels are re-established, it is temping to speculate that patients could still suffer from adverse sexual effects several months or even permanently after finasteride discontinuation. There are currently no satisfactory treatment options for post-finasteride syndrome. It's when you lose the regrown hair when you stop taking fin or something? My total t is 650 ng/dl. Skin Appendage Disord. 100% agree. Bookshelf But that warning isnt prominently featured. Segment on German network WDRs Tricks of the Beauty Industry, June 30, 2021. Epub 2021 Oct 21. Essentially, the cells get too much DHT, it puts them in overdrive and it burns them out. A group of Italian researchers gave finasteride to rats and noticed that the number of androgen receptors in their brains went up. Some people actually report dramatic improvements in their symptoms after starting a certain SSRI. All healthcare providers should learn about these conditions as finasteride/SSRIs are commonly prescribed. With that in mind, DHT can take anywhere from4 weeks to 2 years or more to recover(R). Propecia (finasteride) for Androgenetic Alopecia "I have PFS (Post-Finasteride Syndrome). Course. Healthcare Professionals should carefully monitor patients during treatment with finasteride for psychiatric symptoms (including anxiety, depression and suicidal ideation). These findings may prove crucial to understanding the neurochemical mechanisms of FINs neuropsychiatric side effects. The Bottom Line: It is important to know that those who experience hair loss are more likely to report depression, so clinical trials are needed to conclusively determine whether finasteride causes depression and anxiety. My yardstick for treating any patient is, what would I do if this were my own son? Psychiatric Comorbidity Related to the Therapy of Male Androgenetic Alopecia Independent of the 5-Alpha Reductase Pathway. Disclaimer. Its Monday, which means its time for a poll! Available toxicity information from clinical trials of finasteride in men with [androgenic alopecia] is very limited, is of poor quality, and seems to be systematically biased. Shockwave therapy for ED. This field is for validation purposes and should be left unchanged. My test blood is perfect. Response (via Twitter) to medical student Rainy Horowitzs question: What sex-med topics do you think urology residents would most benefit learning about? sharing sensitive information, make sure youre on a federal I have had retraction of penis and man boobs. We wouldnt recommend that any man take the drug, especially not young men. : October 27, 2021, Statement (via Twitter) to research colleague: October 27, 2021. Unfortunately, some of the side effects of finasteride are more serious and persistent than the original condition it is intended to treat [W]e encountered a surprising association between finasteride use and presence of optic neuropathy or retinopathy To worsen the situation, the neuropsychiatric impact of finasteridechanges in mood and behaviorcan alter practitioner perceptions about affected patients, resulting in a psychosomatic diagnosis. No Fun. is a recovery really possible? Four clicks per day at .25 mL each. Men who take finasteride for baldness or receding hairlines can develop sexual dysfunction. sharing sensitive information, make sure youre on a federal A growing number of doctors, researchers and therapists have in recent years been voicing their concerns about finasteride's potential to cause persistent physical and mental side effects, known as post-finasteride syndrome (PFS), in a subset of patients. When prescribing antidepressants, the advantages and disadvantages must be carefully weighed, as some antidepressants may improve the symptoms of depression but have an unfavorable effect on sexual function. (2009) of 2017. Post-Finasteride Syndrome: An Endocrinologists View Endocrinologist and Pediatrician: August 2022. Post-finasteride syndrome: a surmountable challenge for clinicians. So thankful to have found this article. I got Post Accutane Syndrom, which is related to PFS, there is a down regulation of 5 alpha reductase 1. There was circumstantial evidence that PFS may represent a delusional disorder of the somatic type, possibly on a background of a histrionic personality disorder, which would explain the refractoriness of the condition and a high degree of suggestibility.

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