Nait's story. Extreme insomnia and head pressure

Welcome to our community. Please fill in the following template as a way of introducing yourself, and helping others to understand your background and situation.

What is your current age, height, weight?

25, 188 cm, 63 kg.

What specific drug did you use (finasteride, dutasteride, saw palmetto, isotretinoin/Accutane, fluoxetine, sertraline, citalopram, leuprorelin, etc…)?


What dose did you take (eg. 1 mg/day, 1 mg every other day etc.)?

1 mg. every other day.

What condition was being treated with the drug?

Androgenic alopecia.

For how long did you take the drug (weeks/months/years)?

3 years and 8 months.

How old were you, and WHEN (date) did you start the drug?

20, August 2016

How old were you when you quit, and WHEN (date) did you quit?

24, May 2020

How did you quit (cold turkey or taper off)?

Cold turkey.

How long into your usage did you notice the onset of side effects?

The mildest ones were inmediate; gynecomastia was at a year and a half and the insomnia started after three years.

What side effects did you experience that have yet to resolve since discontinuation?

Extreme insomnia, head pressure and little pain on my chest.

Check the boxes that apply. You can save your post first, then interactively check/uncheck the boxes by clicking on them. If your symptoms change, please update your list.

[X ] Loss of Libido / Sex Drive
[ ] Erectile Dysfunction
[ ] Complete Impotence
[ ] Loss of Morning Erections
[ ] Loss of Spontaneous Erections
[ ] Loss of Nocturnal Erections
[ ] Watery Ejaculate
[ ] Reduced Ejaculate
[ ] Inability or Difficulty to Ejaculate / Orgasm
[ ] Reduced Sperm Count / Motility

[ ] Emotional Blunting / Emotionally Flat
[ ] Difficulty Focusing / Concentrating
[ ] Confusion
[ ] Memory Loss / Forgetfulness
[ ] Stumbling over Words / Losing Train of Thought
[ ] Slurring of Speech
[ ] Lack of Motivation / Feeling Passive / Complacency
[ ] Extreme Anxiety / Panic Attacks
[ ] Severe Depression / Melancholy
[ ] Suicidal Thoughts

[ ] Penile Tissue Changes (narrowing, shrinkage, wrinkled)
[ ] Penis curvature / rotation on axis
[X ] Testicular Pain Very mild.
[ ] Testicular Shrinkage / Loss of Fullness
[ ] Genital numbness / sensitivity decrease
[ ] Weight Gain
[X ] Gynecomastia (male breasts) It disappeared despite continuation.
[ ] Muscle Wastage
[ ] Muscle Weakness
[ ] Joint Pain
[ ] Dry / Dark Circles under eyes

[ ] Prostate pain
[ ] Persistent Fatigue / Exhaustion
[ ] Stomach Pains / Digestion Problems
[ ] Constipation / “Poo Pellets”
[ ] Vision - Acuity Decrease / Blurriness
[ ] Tinnitus (ringing or high pitched sound in ears)
[ ] Hearing loss
[ ] Increased hair loss
[ ] Frequent urination
[ ] Lowered body temperature

[X ] Other (please explain) Insomnia, constant head pressure, some shortness of breath, hypersensitivity to sounds.

What (if any) treatments have you undertaken to recover from your side effects since discontinuation of the drug?

Mirtazapine 15 mg.

If you have pre or post-drug blood tests, what hormonal changes have you encountered since discontinuing the drug (please post your test results in the “Blood Tests” section and link to them in your post)?

None. Everything normal.

Tell us your story, in your own words, about your usage and side effects experienced while on/off the drug.

I developed mild insomnia after three years on the medication. It was like this: I always woke up with a strange activation feeling and some dizziness after 5 or so hours of sleep, and it was impossible to go back to sleep. It was the same almost every night and I am someone who never had big trouble sleeping before this. Sometimes it was better, sometimes it was worse, but I could even take naps and there was some very exceptional nights were I slept normally.

After 6 months with this very physical insomnia, having tried a lot of things, I started to think finasteride could be causing it. I stopped for just 17 days without any medical advice, remembering when I had gynecomastia and it dissappeared on its own. Nothing changed and I just restarted finasteride. I started developing a head pressure and like four pills later (a week) I got a night of 0 hours and I couldn’t take any naps, so I was terrified. It was like I was never going to get to sleep despite not having slept at all. I took lorazepam to get through the next night.

I had pretty much the same sensation next nights, but it is unclear how my sleep pattern was because I used lorazepam in a dosified way; I started to believe the terrible things people talked about finasteride and I panicked.

That week I went to the doctor. He told me to stop finasteride (which I obviously already had done after the night of 0 sleep) and asked for some analysis which came normal. He prescribed trazodone.

During the first doses of trazodone I didn’t know how it was helping me. I slept like 3, 2 or 4 hours. There was a very paradoxical night in between, at the second dose of trazodone, when I slept 8+ hours, something that already had happened to me during the mild insomnia. It remains a mystery to me why.

My sensation was that trazodone was stopping working after 4 weeks. I got a night of zero and no sensation of ever going to get sleep and I again panicked, used lorazepam next night and went to the doctor. I now regret a bit not having tried me for next night, but as I could not get any naps I did not think too much about it, it was enough for me.

Head pressure was tremendous since I restarted finasteride and remained almost the same despite nights of decent sleep. It is generalized. I feel it in the middle of my head, in the inside, and it is constant. Lorazepam seemed to disipate it a little. I had a head MRI which showed nothing relevant.

Long story short, I was prescribed mirtazapine which has worked pretty good for eight months and hasn’t given me any side effects, but it likely started to stop working for sleep a month ago :slight_smile: so now that I am restarting my master’s degree I am again sleeping 0 to 4 hours. Sometimes the sensation is that I got enough rest despite being half awake.

Of course, I don’t really know what my current ‘natural’ sleep pattern would be like but I am holding the 15mg of mirtazapine. I was recently talking to a member of this site who suffered from extreme insomnia from saw palmetto and has improved a lot with the use of glycine and magnesium, and I will be cautiously looking for routines that promote regeneration.

I remain very positive though having nearly lose my head these days; I am mostly coping with extreme regret issues about having restarted the drug and extremely agravated the insomnia.

I am a passionate person with ups and downs but I am certainly good at bringing energy to get through things.

Also, I was going to say that I kept myself cautious with using this website. I did not want to come and write anything before I had something wide to tell, some general storyline. When so many people come here to tell how they are from one week to another, a lot of info is mixed up; I think it works like that in the general perspective despite how well versed some members are; and, of course, it depends a lot on how the forum is used, but the psychollogical aspect is, in this situation, something to treat with cautiously and it takes a good part in it.

There are more things I would say, like, being this a serious issue which is partially supported by doctors, the fact that this place is not moderated by any doctor really breaks me. But this situation is surreal enough from the beggining in so many aspects.

I wish a great amount of time and some regenerating routine eventually will make my extreme insomnia and head pressure better.

Hi @Nait I remember we have spoken before , over pms .

Again your story and experience is similar to mine , I was doing a lot better the second half of 2020 but something caused a terrible relapse in late December and I’m back to the 0 - 2 hours situation at the moment . With Zopiclone it’s 4-6 hours …

There’s something even more desperate about it this time round, I’m really suffering . I sometimes wonder how a human being can survive on so little sleep …somehow I’m still here and alive ?!

It sounds like you have connected with doctors more over this issue - whereas I have not been able to do that successfully . Do they know what causes this insomnia or is there some prognosis for it ? Have you had any sleep study or neurology visits ?

I know there’s some agreement on here that the insomnia is from where finasteride fucked with GABA but some people also think it could be excess cortisol levels or even adrenaline being released , wonder if you had any doctors input on it all?
I’m sorry to hear you are doing rough though, hang in there! You’re not alone with this thing trust me - and I’m sure there will be a way through :pray:

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Im pretty familiar with head pressure, a few thoughts.
It could be caused by sinus issues, inflammation, I also have feelings of ear fullness.
Chronic sinus infection?

Heres another somewhat random thought but some might know what im talking about,
glucocorticoid receptor Upregulation, it could go hand-in-hand with Androgen Receptor upregulation if true.
This could cause increased stress response, anxiety and depression as well.
Maybe headaches.
Honestly some of what might be going on in this realm could make you feel like your losing your mind, and it will take a toll on healthy cognitive function and sense of well-being.

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One of my doctors says my insomnia is ‘primary, idiopathic’. It means it has an unknown inner cause. He agrees that finasteride could have caused it but he thinks the important think is that I sleep first. I am looking forward to speak with him in order to go beyond, maybe to do what you mention. We’ll see.

I am sorry to hear that. But if you have been doing much better no long ago, just look forward to the good sleep that is awaiting you. Going through the day on two to zero hours of sleep is hard. I have been able to attend lessons after nights of zero sleep though, starting the day with cold showers and walks. And experiencing such an extreme insomnia also makes me enjoy sleep even if its for two hours xdd. When I don’t sleep at all I even enjoy resting and letting my mind wonder. But yeah, it is difficult.

In my case, I don’t know if stopping finasteride would have aggravated the insomnia because I only stopped for 17 days, and I took 3 mg per week. All I know is that having stopped-restarted is what aggravated it. It is complicated. I don’t know how I would be sleeping without mirtazapine at the moment; it feels like the same than nine months ago, but that pattern isn’t clear either because I did not want to stay awake for more than 24 hours then; and the med has been losing effect for a month but I still sleep something.

This seems to be about trying things; being everybody different and a different case; there seems to be some that generally help.

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It doesn’t seem to be sinus related. It came along with the extreme insomnia when it became worse. It is like things in my head were disposed differently; it is constant and comes from the center of my head.

As long as I have researched, I think it could have something to do with this:

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Yea im not sure. There was a guy that had intense head pressure that had taken Accutane who went as far as having a lumbar puncture and they didnt find anything.
I believe he was prescribed prednisone and he later said it made things worse.
That person you quoted seemed more intent on wanting everyone to know how smart he was without really helping anyone.
It didnt make alot of sense to me.
There has been talk about GABA receptors (including from myself), but at this point what hasnt been covered?

If you search “sinus” up at the top you’ll find 50+ results, so it is an issue quite a few have noticed not just specific to PAS meaning PFS as well.

Going back to that though,

Retinoic acid functions as a key GABAergic differentiation signal in the basal ganglia

That’s interesting. I came with that because it is what makes more sense to me, as it came with the variety of symptoms such as insomnia, irregular heartbeat and shortness of breath.

All these symptons are commonplace with anxiety disorders. A chronic tension headache appears to be something ‘normal’ on people with anxiety disorders. But all mine were inmediately triggered by finasteride and the pressure is here every moment of the day.

The thing with sinus is that I don’t really feel anything in the sinus area. I have experienced sinusitis and it felt very differently.

I would agree that the most logical connection one can deduce between finasteride and the insomnia/head pressure is through some sort of dysfunction of the GABAergic system.
I believe that once finasteride is withdrawn from the body. It creates a surge of allopregnanolone which is no longer being inhibited. In my opinion, this causes the body to either reduce GABA receptor density, receptor sensitivity or completely turn of 5a-reductase activity to compensate for the large influx. For most people the body will return to homeostasis after a short amount of time. But for others this appears to either take a very long time or doesn’t really happen significantly enough.
Depending on our problem

I believe that the biggest roadblock to fixing the issue with our GABAergic system seems to be figuring which of the three problems or combination of the three problems is affecting us individually (as everyone is different and would react differently to withdrawal from finasteride).

Obviously I’m not a neuroscientist, and the above post is just my opinion.

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As I said very similar situations we have !

That scenario mirrors my sleep struggle currently …the past 3 nights have been , 1 hour sleep , then I got 2 , then last night about 3 - 3.5 .
As you say you are even greatful for that extra 1.5 hours last night !
I definitely feel slightly better lol but to anyone else who was ‘normal’ this would be an extreme insomnia by itself .
The trouble is , the nights of 0 sleep are the worst so even getting 2-3 hours feels like something , as you say .

Well I’m part way through a sleep study , I’m due to go in and have the second part done where I stay in the hospital for a night .
Currently - the temptation to reach for another Zopiclone is great , but I’m trying to go as long as I can without and see if I can get some kind of reset with magnesium and CBD . Definitely feeling rough today !

On the plus side all these people going to places for sleep problems and erectile problems etc it will only be a matter of time before doctors start thinking …ok we are getting a lot more people because of this thing , maybe there is something going on here .

That’s what I hope anyhow !

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Yes. That is very plausible.

But in my case, I developed insomnia while on finasteride and worsened it by stopping-restarted. Then, I inmediately started on meds because my sleep pattern was miserable.

So I don’t know if the withdrawn would have caused any major imbalance. It is kind of a mess.