hi there, im not very good at participating in these kind of things as i never done so before… but i have to thank you guys… can i tell you bit about my story??
well i work as a doctor. on this med for last 10 years or so side effects exactly as described here have been driving me crazy to the point of almost giving up…
i am so thankful to yo all… i would love to help in any way possible.
cheers
and God bless
so you are a doctor, you took propecia and have suffered from side effects?
did you write a report of any kind to inform the doctor community of your country about this ?
thanks for your reply.
yes i am a doctor. I have been suffering very severe side effects especially cognitive ones… which is most humiliating when you stagger over your words especially in clinical meetings with your colleagues or the wrong words actually come out… also trouble explaining things to patients… especially if they are very articulate they pick up on it very quickly…
in the last several years things have been really bad… i suppose its also my fault for taking 2.5mg per day…
the irony is that i work in the field of psychiatry and have been feeling more and more like my patients!!! to the point of seeing a psychiatrist myself. my main complaint was my cognitive side effects especially the ones interfering with my work and also the depression-like symptoms of a poverty of thoughts, very slow processing of information, terrible memory and recent recall, etc. etc… the psychiatrist i went to for about 3 years in 2003 only suggested that i get tested for ADHD but apart from that was giving me psychotherapy… which was nice but did not help the problem. I stopped seeing him.
Last week i referred myself to another psychiatrist… that was after also getting severe physical symptoms like severe palpitations, rapid heart beat, blurry vision to only name a few. I also havent been able to cope at work due to the cognitive side effects. I admitted a patient last week (which is quite involved… lots of paperwork…) i found it so hard to write the admission… all the words got jumbled up and i couldn’t even spell the most basic words!! …apart from that i have been feeling so dissociated from this world as if i was watching a movie… and not to mention the ‘psycho’ dreams which have been so distressing…
… anyway sorry to drift off the topic… this psychiatrist i saw last week told me my presentation had an ‘organic feel’ to it… ie that it seems like there is something physiological wrong. He suggested i have a full organic work-up including bloods etc. Instead i started looking at the net and discovered this site.
i feel like i have been poisoned… for many years!!! and no i am not paranoid (like many of my patients)
sorry to be so circumstantial… to answer your question i didn’t write any report about this because i wasn’t aware. I didn’t realise… eventhough i am a doctor i don’t like taking medications myself but felt concerned enough about my hair loss which struck me gradually from about age 19… to take this tablet but would never imagine that it could cause such a chaotic state in one’s body!!
so I hope i have answered your question.
I am going to discuss with my colleagues and seek advise…
hope i stay sane in the mean while
thanks again…
by the way i live in sydney australia… does anybody else??
I think you are the first on this board (maybe I am wrong) to be a doctor.
I hope you will convince your collegues that there is something wrong with this drug.
Today they all refuse to believe it, so there is no report and no awareness, and everything stays the same everywhere and nothing is done to help us.
I am not paranoid either ! Before this , I only went to the doctor 5 or 6 times in my life.
But how to convince a doctor that your symptoms are not mental, when you have nothing to show to him (even when you have something, like slight gyno and veins on your dick like me, they dont believe you).
I hope you will be fine and you keep us informed about your action.
Maybe as you are a doctor you will be able to get much more consideration from your collegues than we do.
If you are a doctor I would advise you to review the medical literature on this site and talk to your colleagues, have them read it too, and perhaps do an investigation into why men like us continue to suffer these problems despite quitting the drug.
In addition, you can help bring awareness to the medical community about the dangers of this drug, since you seem to be experiencing the side effects yourself.
Finally, if you are in the medical system you have all the tools at your disposal to unlock the answers – access to colleagues, researchers, blood tests, geneticists. It would be great if you could leverage these connections to figure out the root cause(s) of the Post-Finasteride syndrome.
You mention you are in Australia – where is your practice located, what is your name?
one important point to mention is that relating to metabolism. I have lots of experience with my patients in the field of psychiatry… using medications such as antidepressants, mood stabilisers and antipsychotics people seem to respond in different ways. its quite amazing how one patient could suffer side effects at low doses and another patient hardly any side effects at much higher dosage.
this relates to the rate of metabolism… in our case by the liver. A person can be either a fast or a slow metaboliser. If a person is a slow metaboliser, he is much more likely to hit toxic levels of the drug at lower doses…
an important consideration would be to do finasteride levels in the blood… im not sure how accessable this is … does anyone know?? that would be very helpful
in my case it seems like i reached toxic levels on 2.5mg per day… for the last several days i reduced to 1.25 per day and must say feeling much better thanks to you guys!!
i am much more alert, less brain fogged and less depressed… also the palpitations have stopped!! quite a change after only few days. i still get very fatigued in the middle of the day at the half life of the drug.
i hope this is bit helpful and lets explore this issue of blood levels further.
thanks
Yes the drug is heavily metabolized by the liver’s P450 system, specicially CYP3A4.
cat.inist.fr/?aModele=afficheN&cpsidt=3688902
The drug has a near flat-dose response rate according to Merck’s materials as submitted to the FDA for the Propecia trials. Thus 0.25mg is almost the same effect as 5mg on DHT inhibition.
physics.upenn.edu/facultyinf … peciafda2/
If you are a psychiatrist, can you tell us what the consequences of inhibiting Allopregnanolone and THDOC synthesis, and interfering with GABA-A receptor function, would be?
So you are still on the drug? If so your symptoms will not likely clear up unless you quit. If you are a medical professional I would advise you to research this medication so you are aware of it’s many mechanisms of action beyond just “reducing DHT”… curious if you did in fact do this prior to taking it, or simply trusted Merck’s literature? 
Many people have their bloodwork on this forum after taking the drug and finding their Testosterone, LH, FSH crashed and have been left with symptoms of secondary hypogonadism and other hormonal imbalances. Drug is known to alter androgen/estrogen ratio in favor of Estrogens (gynecomastia), changes a man’s hormonal profile to match that of a 5AR2-deficient pseudohermaphrodite, and involutes the prostate – for starters.
I would advise you to get bloodwork if you plan on continuing the medication, also suggest you read the FAQ at top of this site. Unfortunately if you are having side effects, they will likely not go away unless you quit, no matter how much you reduce the dose (due to near flat-dose response).
sorry Mew,
i was writing my note when you posted yours…
why some people have persisting side effects is obviously not clear, however it most likely relates to an issue to do with upregulation or downregulation of particular enzymes over time as the body adjusts to the drug…
from that point of view i would add that it may make sense to slowly wean off the drug and not abruptly to make it easier for the system to readjust and get back to baseline functioning…
sorry when i said blood levels i meant that of finasteride specifically.
also re your question i did read the info from drug company briefly but didn’t you know??
1. doctors make the worst patients… and
2. doctors know NOT to trust drug companies…
cheers
Finasteride inhibits the 5AR-II enzyme, and thus 70% of serum DHT (dihydrotestosterone).
Once you quit taking Finasteride, 5AR-II enzyme is no longer inhibited, takes ~10-14 days to regenerate, and consequently DHT to start to return to baseline.
Since DHT acts on (binds to) the androgen receptor to exert it’s effects… in your opinion, would taking the drug upregulate (due to lack of androgen, ie DHT) the androgen receptor to be more sensitive, or downregulate it since there is no longer enough androgen (DHT) to active it?
Or, is it possible 5AR-II enzyme production has been downregulated? Problem with this is some people have high serum DHT levels, thus it would seem to not be the case (ie, 5ARII is functioning correctly post-Fin).
i think its complex, for example it can change over time. best to ask an expert in that field…
also i think it does not help to get too technical about it as no one really knows… it might be better just to monitor levels in the blood of hormones as well as finasteride (even though half life is quite short there may be an accumulation over time… some drugs do that) and also to do things cautiously ie in terms of increasing or decreasing doses… that is the general rule used in psych…
Unfortunately without being technical we will never get to the root cause of why men like us continue to experience the problems we are experiencing. In order to reverse engineer the damage, medical professionals and researchers would need to understand Finasteride’s many mechanisms of action to as a starting point for further investigation. So I will have to disagree with you on that point.
Also, if one is to prescribe drugs as a medical professional, I would think it is imperative that they at least have a basic understanding of how the medications being prescribed operate, to hopefully avert potential problems/side effects etc should things not go according to plan.
Monitoring hormones should be done BEFORE, during and after taking the medication – unfortunately hardly any docs ascribe to this and thus most men have no baseline to go against should they have problems down the road from the drug.
Measuring Finasteride in the blood directly is not possible to my knowldge via routine blood tests, but more via doping bloodtests or in a research lab. For example: propeciahelp.com/forum/viewtopic.php?t=568
Also: some men have perfectly optimal hormone levels post-Fin, yet continue to have issues. So while there is a hormonal component to all of this, it may go deeper than that or the problems may lie elsewhere.
Anyway – if you’re a psychiatrist, I assume you are able to provide insight into the roles of neurosteroids like THDOC and Allopregnanolone, and GABA-A receptors in the brain. Can you tell us what the potential problems of interfering with their normal function would be?