> Concerns about depression from finasteride were raised in several studies as early as 2002.
It seems clear to me that anything which has depression as a side effect has an increased risk of suicide as well and the only remaining truth to find is the degree.
The executives and scientists should both be prosecuted.
I'm shocked that this wasn't widely known in the US. Reports from trans people, way back in the 1940s, show clear links between sex hormones and depression: a priori, one would assume such a relationship would exist here. The article appears to allege a cover-up:
> It is difficult to imagine what data could justify hiding in a drug safety review.
I've been sceptical of any direct relationship between "post-finasteride syndrome" and sexual function, but I've never doubted the direct effect on mental health of suppressing dihydrotestosterone in cis men. (Even if the pharmacological effects end shortly after cessation, which I suspect, a sudden and unexplained strong feeling of constant wrongness can be traumatic.) The part I find interesting is that most men seem to be just fine with taking finasteride, even orally.
Not kidding: What about suicides prevented from not going bald? To paint a fair image, this study should also compare suicide prevalence for bald people.
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Results: Compared with the controls, an increased risk of suicide attempts was observed in patients with AA, with an adjusted hazard ratio of 6.28 (95% confidence interval, 4.47-8.81). Suicide risk remained significantly elevated in AA patients when stratified by underlying psychiatric disorders. The mean age of initial suicidal behaviors was also lower in patients with AA.
Conclusions: Patients with AA had a significantly higher incidence of suicidal attempts than controls, regardless of concurrent psychiatric illness. Further studies are needed to elucidate the pathophysiology of the association between AA and suicidality. In addition, dermatologists should be aware of the increased suicidality of patients with AA.
I‘m 24 and bald now. I never even considered taking finasteride. A 1% of getting permanent erectile dysfunction without known cause (PFS) nukes the expected value for me
Might be a good idea to switch to low-dose minoxidil? It seems to have very few side effects, and even then they are benign for most people (slightly lower blood pressure).
This is not a scientific paper. It is a "narrative review", which is another way of saying "editorial". It superficially looks like science, but doesn't do any of the methods, controls or (correct) statistics that you would expect in a legitimate meta-analysis. Do not take it seriously.
The "dedication" at the top should clue readers into what is going on -- it's not even trying particularly hard to look legitimate -- but alas.
Edit: this line, in particular, made me laugh. It is one of the more egregious examples of "pretending to do statistics" that I have seen recently:
> Table 1 summarizes the studies in the last decade examining a potential link between neuropsychiatric reactions and finasteride exposure. When prescribed mainly for AGA, all reports suggest that finasteride can cause depression, anxiety, suicide ideation, and suicides. Assuming a null hypothesis (finasteride does not affect mood) and a 50% chance of 1 result against this hypothesis, the probability of getting all 8 studies concluding against the null hypothesis by chance is 0.58 = 0.0039.
Tried finasteride and my sleep quality was altered ; vivid nightmares and tremors in my legs that would wake me up.
I stopped taking it and those disappeared.
Fwiw.
A word of caution to anyone trying to take health advice from HN comments: don’t.
Want to debate javascript frameworks and linux distros? sure, there’s great knowledge here.
This is not the case for most topics outside of software.
If you followed the health advice here you’d be living in a shed in Antarctica to avoid microplastics, taking shrooms for your mental health and rejecting all pharmaceuticals when you get an infection.
I would extend that to all topics, even the technical ones. The upside to HN is that it attracts a lot of smart, technically knowledgeable people. That's the downside, too. Everyone likes to think Dunning-Kruger is an indictment of over-confident stupid people, but I think it serves us better as a warning to people who think themselves smarter than average. Heck, especially when they are smarter than average.
Trying finasteride was the worst thing I ever did to myself. Traumatic and horrible experience if you are in that small % of people that it will permanently damage and alter your body.
What permanent damage and alterations have you noticed? I suspect these are all attributable to trauma, in which case psychotherapy might resolve them.
I took Finasteride (1mg) daily for 20 years, because both my GP and my wife had commented on my thinning hair. The pills worked, and I didn't have any side effects (that I can positively attribute).
Five years ago, I was diagnosed with CKD (3A), so I stopped taking Finasteride, which was the only prescription drug I was taking. I cannot claim any causal relationship, but I have been happier for these past five years. Of course, it could be because I'm now retired and financially secure. My hair seems to be thinning again, but it's still there.
Concerns about Finasteride are dramatically overblown. It’s one of the most extensively studied and commonly prescribed medications for men. Side effects like these are comparable to placebo. They also conveniently happen to be the same types of effects that can be produced psychosomatically.
Finasteride messes with the testosterone hormonal balance. As testo affects mood, no surprise it can cause depression (although relatively rare) and hence suicidality.
20 comments
[ 2.9 ms ] story [ 32.6 ms ] threadIt seems clear to me that anything which has depression as a side effect has an increased risk of suicide as well and the only remaining truth to find is the degree.
The executives and scientists should both be prosecuted.
> It is difficult to imagine what data could justify hiding in a drug safety review.
I've been sceptical of any direct relationship between "post-finasteride syndrome" and sexual function, but I've never doubted the direct effect on mental health of suppressing dihydrotestosterone in cis men. (Even if the pharmacological effects end shortly after cessation, which I suspect, a sudden and unexplained strong feeling of constant wrongness can be traumatic.) The part I find interesting is that most men seem to be just fine with taking finasteride, even orally.
-------
Results: Compared with the controls, an increased risk of suicide attempts was observed in patients with AA, with an adjusted hazard ratio of 6.28 (95% confidence interval, 4.47-8.81). Suicide risk remained significantly elevated in AA patients when stratified by underlying psychiatric disorders. The mean age of initial suicidal behaviors was also lower in patients with AA.
Conclusions: Patients with AA had a significantly higher incidence of suicidal attempts than controls, regardless of concurrent psychiatric illness. Further studies are needed to elucidate the pathophysiology of the association between AA and suicidality. In addition, dermatologists should be aware of the increased suicidality of patients with AA.
https://pubmed.ncbi.nlm.nih.gov/36921592/
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Not enough time to size these in comparable numbers to this study, but would be really interesting.
Is it a net positive (reduced risk) over just going bald?
The "dedication" at the top should clue readers into what is going on -- it's not even trying particularly hard to look legitimate -- but alas.
Edit: this line, in particular, made me laugh. It is one of the more egregious examples of "pretending to do statistics" that I have seen recently:
> Table 1 summarizes the studies in the last decade examining a potential link between neuropsychiatric reactions and finasteride exposure. When prescribed mainly for AGA, all reports suggest that finasteride can cause depression, anxiety, suicide ideation, and suicides. Assuming a null hypothesis (finasteride does not affect mood) and a 50% chance of 1 result against this hypothesis, the probability of getting all 8 studies concluding against the null hypothesis by chance is 0.58 = 0.0039.
Want to debate javascript frameworks and linux distros? sure, there’s great knowledge here.
This is not the case for most topics outside of software.
If you followed the health advice here you’d be living in a shed in Antarctica to avoid microplastics, taking shrooms for your mental health and rejecting all pharmaceuticals when you get an infection.
Five years ago, I was diagnosed with CKD (3A), so I stopped taking Finasteride, which was the only prescription drug I was taking. I cannot claim any causal relationship, but I have been happier for these past five years. Of course, it could be because I'm now retired and financially secure. My hair seems to be thinning again, but it's still there.
Without getting personal, finasteride didn't worsen my situation.
Why? The topical product is cheap and available and effective. Why choose to take a pill rather than directly target the affected area?