Propecia Side Effects and the Placebo Effect

Hey Dr.Rassman,

What do you think of the placebo effect in regards to side effects associated with taking Propecia? This snippet from Wikipedia on the placebo effect got me thinking about alot of individuals that have expectations/concerns on getting potential side effects from the medication.

Snippet:
Expectancy and conditioning

“In 1985, Irving Kirsch hypothesized that placebo effects are produced by the self-fulfilling effects of response expectancies, in which the belief that one will feel different leads a person to actually feel different. According to this theory, the belief that one has received an active treatment can produce the subjective changes thought to be produced by the real treatment. Placebos can act similarly through classical conditioning, wherein a placebo and an actual stimulus are used simultaneously until the placebo is associated with the effect from the actual stimulus. Both conditioning and expectations play a role in placebo effect, and make different kinds of contribution. Conditioning has a longer-lasting effect, and can affect earlier stages of information processing. The expectancy effect can be enhanced through factors such as the enthusiasm of the doctor, differences in size and color of placebo pills, or the use of other interventions such as injections. In one study, the response to a placebo increased from 44% to 62% when the doctor treated them with “warmth, attention, and confidence”. Expectancy effects have been found to occur with a range of substances. Those that think that a treatment will work display a stronger placebo effect than those that do not, as evidenced by a study of acupuncture.”

Sometimes I feel like alot of us convince ourselves we have these side effects when in reality they are non existent.

I have no doubt that many of the problems with sexual side effects reported while taking finasteride, are impacted by the power of suggestion. Also, some men have erectile dysfunction prior to ever starting the drug finasteride, so it is easy to blame the drug for that problem if they exercised denial. Thanks for sharing this with us.