Finasteride - How likely are you to get side effects?

[Rawtashk]

(this is a copy and past from a response I did on a different post, but I thought it would be good to put it here for people that aren't reading the specific post)

Here's the basic argument that I see when people talk about their side effects:
Person with sides: "I got sides. You will probably get sides. The sides are higher than Merk reported"
Person that didn't get sides: "Well, they have to go through 3 different phases of trials before it's FDA approved, and the results were consistant."
Person with sides: "Merk is a lying scumbag of a company!! Of COURSE they would falsify records and results because it's their product and they wanted to sell it and make money!"

There are PLENTY of finasteride studies done by people other than Merk. For example
Three-year safety and efficacy data on the use of finasteride
http://www.ncbi.nlm.nih.gov/pubmed/7510911
The excellent safety profile and sustained clinical efficacy, over thirty-six months, of daily treatment with finasteride 5 mg recommend finasteride as a low-risk medical option
(Yes, this was a treatment for BHP, but they used finasteride, and at a FIVE mg dosage, not .5 or 1mg)

Or we can just go with a 1mg study on Japanese males with male pattern baldness
Evaluation of efficacy and safety of finasteride 1?mg in 3177 Japanese men with androgenetic alopecia.
http://www.ncbi.nlm.nih.gov/pubmed/21980923
Adverse reactions occurred in 0.7% (23/3177) of men


So, here is what we have"
A finasteride study done by Tokyo Memorial Clinic, NOT Merk.
3177 men took 1mg finasteride daily for 3 years and 5 months.
87.1% of these men experienced hair regrowth
Out of 3177 men, only 23 had any reported side effects. That's POINT SEVEN PERCENT.

Say all you want about Merk being corrupt and lying (and I would tend to agree with you, to some extent), but this is a large scale study done by someone OTHER than Merk....and it happens to back up every thing that Merk reported in their studies! Merk tested around 700 men, and this study tested almost FIVE TIMES as many guys as the Merk study did.

Does this mean that no one will ever get sides? No. Does it mean that PSEs are a myth? No. It means that it is highly unlikely that you'll get them.


Also...just as another point of interest...in the Merk study there were .7% of men that reported a difficulty getting an erection. Turns out those .7% of the guys happened to also be in the placebo group! Pretty sure a sugar pill didn't cause that problem....
(there were some that reported the erection problem who were in the finasteride group as well, but this point was made specifically about the power of the placebo effect and the power of your mind)

 

[Wuffer]

It's good that you are highlighting some of these studies, especially the newer one that came out of Japan. I just wanted to add my thoughts about all of this as well. Hopefully this will help clear things up for some of the newbies considering Finasteride treatment.

I've been seeing a lot of talk lately that reported side effects from the FDA trials of Propecia were faked, and/or Merck influinced the results. There is no proof of this occurring, or any proof that this has ever occurred in any study of Finasteride. There are people out there that believe it is justified to lie about these facts in order to scare others away from ever taking Finasteride. These people believe they are simply doing a public service, but in reality they are taking away a very effective treatment from others. Some people don't realize how deeply hair loss can affect some individuals, and scaring someone away from treatment because of your own negative experience is just not right.

Side effects CAN and DO happen. There is also a chance these could persist after taking the medication. IT COULD HAPPEN TO YOU. However, keep this in perspective. It's very rare to experience side effects while taking it. Dozens of studies have been done on Finasteride over the course of more than a decade, and all of them show more or less the same incidence of side effects: approximately 2%. There is simply NO arguing with this fact, no matter how much some people disagree with it. Additionally, persistence of side effects have not yet been identified in any studies i've seen. However, over 10,000,000 people (probably double taking into account generics) worldwide have taken Propecia, and there are thousands that complain of persistence. This shows that it is likely extremely rare, but it COULD happen. Whether you are willing to take that chance is entirely up to you.

One more point I would like to make is that the existence of psychosomatic side effects and the nocebo effect are real, and have been demonstrated over and over again in numerous studies. These effects are extremely powerful, and I personally believe they account for a large number of finasteride side effect experiences and horror stories, especially with people who often frequent hair loss forums.

I thought I would throw this out there; there was a small scale study done on the 'nocebo' effect with patients taking Finasteride (see attached picture). It was demonstrated that merely the suggestion that this medication may cause side effects causes them to actually happen up to 4 times as often, compared to a group that is not informed. Unfortunately this study did not include an informed / non informed placebo group, but that was not the intent.

My final piece of advice for someone considering finasteride treatment is to do your research. If you are a reasonable, level-headed individual, go ahead and read the forums and read the studies. However, make sure you are asking the right questions when considering information. Is this information sound? Is there a study or actual data to back up the numbers? Is an individual making a claim based on their personal positive or negative experience with the drug? I can see how insanely frustrating it must be for someone consdiering treatment now a days, so hopefully these posts help you make your decision a little easier.

 

[Rawtashk]

Wuffer, I freakin LOVE that graphic! Your mind is such a powerful tool. Can you link to that whole article/study instead of just a picture? I can foresee people (such as TravisB and Joe1991 [or whatever new username he picks]) coming in and claiming "PHOTOSHOP!!!" :woot:

 

[IrishFella]

No matter how many official stats you pull the unfortunate people that have experienced side effects or people that downright refuse to take it will say other wise.

You have a very little chance of convincing them not matter how much proof you put in front of them.

And brilliant post's lads, I always enjoy reading your input into things like this especially Wuffer, you post some brilliant stuff.

 

[dsbhaver]

Fantastic post!!

 

[Technical]

I too am going into a neuro focused field, presently I'm focusing on pre-med as well as psych to attempt to enter either neurology or neuropsychology.

It's funny that he should mention Myleination and GABA production. He skims over GABA before even mentioning it.

I can't stress enough how awful finasteride is. Any drug that is broad in its treatment will cause reactions in the system so vast that it's impossible to control for, and although they may not present right away, they very well can later.

"Allopregnanolone formed in peripheral tissues readily enters the brain where it acts to enhance activation of GABA. A receptors"

Anyone who's done any sort of research should immediately be scared when they read this. A lack of GABA causes widespread reaction around the entire body. This can lead to hypertonia and a wide variety of things like for example slurred speech or shaking/twitching. As GABA acts as an inhibitor in the excitation of the nervous system.

This also explains why some claim to be more fatigued, or I've even heard of people who complain about muscle twitching as a side effect.

Regardless the point is that when you have a drug that isn't targeted it's going to cause problems you can't see now, but may come later. The same goes for those who may have a period of rampant drug use early in their lives, although being taken off the drugs may solve the symptoms, the damage to the system has already been done. The nervous system is one of the least regenerative systems in your body. Neurons are rarely regenerative.