Finasteride Operates as a Neurosteroid Inhibitor
Dr Rassman, if you would do a little more digging, you’d realize that besides inhibiting 5AR2 reduction of Testosterone to DHT, Finasteride also operates as a NEUROSTEROID inhibitor of Allopregnanolone and THDOC synthesis, neurosterois which can then no longer act properly on GABA-A receptors in the brain.
See page 3 for diagram: PDF file at CNS Drug Reviews
Also, from Journal of Neuroscience
“This may have implications on the clinical use of neurosteroid synthesis inhibitors such as finasteride (Propecia), because certain neurological disorders related to steroid hormone changes may be worsened by finasteride treatment (Herzog and Frye, 2003).â€From Journal of Andrology
Notably, preliminary studies indicate that, as in the rodent, finasteride may increase depression in men as a result of the loss of allopregnanolone (eg, Altomare et al, 2002; Rahimi-Ardabili et al, 2006).This raises the possibility that lowered levels of the neurosteroid contribute to the reduced sexual desire reported for some patients.â€
Clearly the dermatology community loves to downplay the true sexual, physical and mental health risks of this drug — to admit the truth would be financial suicide. The fact is, neurosteroid inhibition via Finasteride can effect one’s mental health, if one is susceptible to such inhibition.
Perhaps you should try the medication yourself for 2 years Dr Rassman, and see how less mentally sharp you become… in addition to the possibility of altering the androgen/estrogen ratio in favor of estrogens, developing gynecomastia, penile fibrosis due to depleted DHT levels, loss of morning and spontaneus erections, and prostatic involution — just for starters.
If you were to experience these issues as many other men have thanks to this drug, I doubt you’d be so dismissive of the effects of androgen deprivation therapy via 5AR inhibition.
I’ve been on Propecia for well over 2 years and I still have the mental capacity to run multiple businesses, develop new tools and techniques, perform surgery, and even write a daily hair loss blog. Not only have I not seen any negative side effects from the medication, but the great majority of my patients that take the medication haven’t reported these side effects to me either. Before I started this site, it was very, very rare that I had read/heard any reports like that. The Internet provides a very big megaphone for those that have problems, real or perceived.
I have posted your opinions and your references. I appreciate the time you took in collecting the sources and quotes. Clearly the readers need to draw their own conclusions.
Well, I was on finisteride 5 mg for about 14 years before I switched to Avodart a few years back. In fact for the first few years, I was popping Proscar (finisteride 5mg) like candy, about 20mg a day cause my Health insurance covered it. They got wise and finally figured out that a 27Yr old guy (I’m 43 now) wasn’t taking it for BPH and stopped paying for it so I cut back to 5mg. LOL!
No side effects whatsoever.
This Brain Fog thing is just an internet rumour with no hard science to back it up.
Physicians should be more forthcoming with the possibility of neurologically related side effects with respect to 5AR-2 reduction therapy. Physicians have all taken oaths to protect the interests of their patients, and simply because the mechanisms of injury or possible deleterious side effects of a medication have not been fully elaborated, that doesn’t mean the effects are not real in some individuals. Even if the risks are small and not well understood, a physician should feel it is their obligation to explain these risks to all of their patients fully.