More Propecia Side Effects Discussions

[Wuffer]

Do you even know why the study was conducted or how Dr. Irwig reached his conclusions?

Yes, because I read the study and it explained how it was conducted, and it makes absolutely no sense.

A logical study would be to determine the potential for depression, anxiety and suicidal thoughts in people taking finasteride. The correct way to do this would be to study two groups: one group taking finasteride, and one group taking a placebo. After a set time, test groups and compare results.

However, Dr Irwig for some reason is comparing depression/anxiety/suicidal scores from a hand-picked subset of patients already exhibiting sexual dysfunction, to a group of people who have never taken finasteride. How does this make any sense? This introduces a massive bias into the study parameters. It doesn't matter what statistical methods he used; his group selection is ridiculously biased to start with. Of course 61 men who have sexual dysfunction will be more depressed than a group who have normal sexual function.

This is exactly the same as comparing a group of left handed cancer patients to a group of left handed people who do not have cancer. The study would invariably show the cancer group is more depressed. The rational conclusion is that the people are depressed because of the cancer. The irrational conclusion would be to argue that being left handed causes depression.

 

[Quantum Cat]

Any study should be placebo controlled and preferably double blind, otherwise it opens it up to all kind of intentional and unintentional biases.

It sounds suspicioulsy like Irwig had an agenda before he even started the study, which is shamelessly unscientific.

I recall him talking about Propeciahelp.com and surmising that because the board had thousands of members, then therefore thousands of men must be experiencing permenant post-finasteride sides! What a ridiculous thing to say - the majority of an internet messageboard's membership are spambots and one-post shillers (like this one). Propeciahelp still has threads dating back 3-4 years... on the first page! I can't believe a supposed scientist could make such an absurdly false corellation. Basically, Irwig's methods and credentials appear suspect at best - and that particular 'study' is null and void.

I do think there's a need for a much more rigourous, unbiased study into Finasteride

 

[Allen Parks]

Wuffer, your discussing the clinical trials and making conclusions about them without even reading them speaks volumes about your (lack of) integrity and intelligence. You cannot expect to be taking seriously when you say things like ""These conditions almost never show up in placebo controlled studies, and you would be hard pressed to even find case reports," when you admit you didn't even read the study and that these conditions do, in fact, frequently show up in studies. I'm not going to spoon feed you the link, but if you want to read the studies you keep talking about, it's available to anyone online. It's on the FDA's AccessData site. You can figure out the rest. Save yourself the embarrassment and don't discuss the studies until you read them.

 

[Allen Parks]

Yes, because I read the study and it explained how it was conducted, and it makes absolutely no sense.

Oh so many things wrong with your post there's no way I can address them all. It's been suggested you're a paid rep for a company with a vested interest in finasteride. Maybe so. But your arguments are so asinine I find it hard to believe anyone would pay you to argue for them.

"A logical study would be to determine the potential for depression, anxiety and suicidal thoughts in people taking finasteride. The correct way to do this would be to study two groups: one group taking finasteride, and one group taking a placebo. After a set time, test groups and compare results."

So many things wrong with this it's clear you have absolutely no experience or understanding in anything scientific whatsoever. You are suggesting Dr Irwig run a clinical trial to solely determine the persistent adverse effects a drug has on subjects. First of all, it's utterly pointless to even mention it because Dr. Irwig conducted Post-Marketing Surveillance study. For one, he would need a budget of hundreds if not thousands of times more than what his department at GWU would allow. That you are even suggesting this shows you don't have even a rudimentary understanding of how science is conducted. It's also highly unlikely administering a drug to see if subject develops depression and suicidal ideation would ever get past the Internal Review Board.

"However, Dr Irwig for some reason is comparing depression/anxiety/suicidal scores from a hand-picked subset of patients already exhibiting sexual dysfunction, to a group of people who have never taken finasteride. How does this make any sense?" How does it not make sense. Dr. Irwig explained this in the very first sentence of his paper. "Less common adverse effects of a medication may only be uncovered in the post-marketing phase."

"It doesn't matter what statistical methods he used;" Sig worthy.

"His group selection is ridiculously biased to start with. Of course 61 men who have sexual dysfunction will be more depressed than a group who have normal sexual function." Ughghghg. God your comments are painful to read. Yes, the men with sexual dysfunction will likely be more depressed than the control group. That's not what being investigated. What's being studied is: How much more depressed are the former finasteride users who developed persistent sexual dysfunction than the control group?

"This is exactly the same as comparing a group of left handed cancer patients to a group of left handed people who do not have cancer. The study would invariably show the cancer group is more depressed. The rational conclusion is that the people are depressed because of the cancer. The irrational conclusion would be to argue that being left handed causes depression." Both a false analogy fallacy and strawman argument rolled into one stupid comment. What part of Dr Irwig's paper led you to this bizarre analogy? Quote him.

 

[Wuffer]

Wuffer, your discussing the clinical trials and making conclusions about them without even reading them speaks volumes about your (lack of) integrity and intelligence. You cannot expect to be taking seriously when you say things like ""These conditions almost never show up in placebo controlled studies, and you would be hard pressed to even find case reports,"

I'm now almost 100% convinced you are Habeas Corpse. You are insistent on making personal insults, and you know an awful lot about finasteride as well as my posting history. You repeatedly re-post the same quotes from me, insist on arguing in circles and refuse to support any of your statements with citations.

you admit you didn't even read the study and that these conditions do, in fact, frequently show up in studies. I'm not going to spoon feed you the link, but if you want to read the studies you keep talking about, it's available to anyone online. It's on the FDA's AccessData site. You can figure out the rest. Save yourself the embarrassment and don't discuss the studies until you read them.

So you wrote up this whole response to me, but you can't be bothered to cut and paste a simple link that supports your argument? If a "quick look" yielded the evidence to show that you are right, all you need to do to embarrass me off this forum is post a link or PMID to whatever studies you are talking about.

 

[Quantum Cat]

Wuffer, his M.O in every sock he's created on here is to post snippets of quoted text he's found on the internet, without linking to any references or sources in an attempt to wind people up. Don't rise to the bait.

Notice he questions your scientific integrity but hasn't answered what his own formal scientific background is (I'm guessing he has none) - and if Admin is right, he's one of those ambulance-chasing lawyers anyway.

 

[Allen Parks]

I'm really shocked at the poor quality of discussion that is allowed here and the accusations of sockpuppetry of new members.

Wuffer, you said "These conditions almost never show up in placebo controlled studies, and you would be hard pressed to even find case reports," yet one Phase of the propecia clinical trials show that over 14% of the finasteride group had a Nervous System or Psychiatric Adverse Event, which was more than the control group.
pg 46
http://www.accessdata.fda.gov/drugsatfda_docs/nda/97/20788_PROPECIA TABLETS, 1MG_STATR.PDF

And I don't know an awful lot about finasteride, not anything that can't be found online anyway. I just have the crazy belief that you should actually read a study before discussing it.

 

[Quantum Cat]

Dood, at least try to give your socks differing personalities...

 

[Wuffer]

http://www.accessdata.fda.gov/drugsatfda_docs/nda/97/20788_PROPECIA TABLETS, 1MG_STATR.PDF

Thanks for posting your source.

The difference between the finasteride and control group reporting these symptoms is only 4 people; a 0.5% difference. Generally from what I've seen, side effects reported at less than 1% are discarded as not statistically significant, but this varies depending on the group size.. Also, "Nervous system or psychiatric adverse event" includes extremely commonly reported symptoms such as dizziness or vertigo.

I did not read this entire report and I have never seen it before. Does it specifically indicate which symptoms were experienced by these patients? A cursory glance over it didn't uncover details, but if these specifics are outlined in the study I will read it (you should know since you did read it)

 

[chicknlittle]

Exactly.... The neurological and psychiatric segment was not statistically different in that study between drug and placebo.

Thanks wuffer and quantum cat for having the energy to address this kind of post. It seems that recently there is a LOT of fear-mongering about propecia,. On other hair loss boards too. While some questions are expected it has felt like sock puppet posting with an agenda (propeciahelp origins)

 

[Allen Parks]

Thanks for posting your source.

The difference between the finasteride and control group reporting these symptoms is only 4 people; a 0.5% difference. Generally from what I've seen, side effects reported at less than 1% are discarded as not statistically significant, but this varies depending on the group size.. Also, "Nervous system or psychiatric adverse event" includes extremely commonly reported symptoms such as dizziness or vertigo.

I did not read this entire report and I have never seen it before. Does it specifically indicate which symptoms were experienced by these patients? A cursory glance over it didn't uncover details, but if these specifics are outlined in the study I will read it (you should know since you did read it)

This is why I was reluctant to post a link. That you would draw your own conclusions based on your misunderstandings. I'll try to clear things up as best I can.

"The difference between the finasteride and control group reporting these symptoms is only 4 people; a 0.5% difference. Generally from what I've seen, side effects reported at less than 1% are discarded as not statistically significant, but this varies depending on the group size."

Aside from the wrong statistic used, when p is less than 1% the data are NOT discarded. How to get p is beyond the scope of this discussion. Please do not attempt to come up with p. Just try to understand what p means. P is short for probability. When you see p, think: probability that the results occurred by chance. When p < 0.01 the interaction has reached statistical significance


At least intuitively you were thinking along the right lines. There is a threshold for what data get accepted and which data get discarded. It's important to note that the threshold is arbitrary. In social sciences, it's usually p < 0.05. In medicine it's usually p < 0.01. Critical safety information can get thrown out, even if p = 0.01. For example, if a drug group is having more Cardiovascular Adverse Events than a Control group, and p = 0.02, the results are not statistically significant, and there will be no Cardiovascular AE warning. Wouldn’t you, as a consumer, want to know if more people had heart attacks in the drug group than the control group, and there was a 98% probability the results did not occur by chance? Unless it’s a greater than 99% (p < 0.01), you won’t get a warning. The statistical methods were developed in the 1920’s, are considered outdated, and have always been controversial. Read The Cult of Statistical Significance for more information.

'Also, "Nervous system or psychiatric adverse event" includes extremely commonly reported symptoms such as dizziness or vertigo.’ Yes. This is a problem with ALL adverse events categories, especially “mental” adverse events. They get lumped into one group. “Depression” goes into the same category as memory impairment and disorientation. Very problematic. Wouldn’t you want to know if your pilot or Air Traffic Controller was taking a drug that could cause disorientation?

“I did not read this entire report and I have never seen it before. Does it specifically indicate which symptoms were experienced by these patients?”
No it does not, nor does it indicate the severity of each group’s symptoms. The Finasteride group could be having severe “Nervous System and Psychiatric Adverse Events” including impairment of memory and suicidal ideation and the control group could be reporting normal depressive moods and behaviors, but we’ll never know. If the data are recorded, it’s in Merck’s database. I have no idea if it is. But they are not required to submit it to the FDA.

 

[Fanjeera]

Nice paper. That way it really is proven finally that finasteride ruins morning erections. What could they mean with "perception problems"?

 

[casperz]

so you experienced extreme lethargy while on finasteride? Did it stop immediately once you stopped taking it?

Yes at times I would say I had extreme lethargy, the difference after stopping was like night and day. For most of 2010 and 2011 I sat around because I had zero urge to do anything and I've always been a self motivated person. Everything cleared up within a month or two of stopping finasteride. I never had any sexual performance issues but random and morning wood was rare.

 

[Quantum Cat]

. What could they mean with "perception problems"?

maybe that Finasteride alters your perceptions so you imagine all kinds of side effects that you don't really have?

 

[Quantum Cat]

ive been on finasteride for 5 years no side effects at all and my hair is still better than baseline

good to hear - no erection/libido problems at all?

 

[spanish]

no nothing at all, I have noticed watery jizz but thats it. Im sure the placebo effect has a major role to play concerning the incidence of sides I never learned about finasteride sides until i had already been taking it for a year so it was never a worry.

Easy for me to say i know considering i have never experienced them but I have a couple of friends on finasteride and they have not had any problems either. I have one friend who was very worried about sides before starting due to spending to much time on propecia help and sure enough he got them .

maybe its just a coincidence but im not so sure.

 

[Quantum Cat]

Easy for me to say i know considering i have never experienced them but I have a couple of friends on finasteride and they have not had any problems either. I have one friend who was very worried about sides before starting due to spending to much time on propecia help and sure enough he got them .

.

I'm saying nothing.... :innocent:

 

[Wuffer]

I have one friend who was very worried about sides before starting due to spending to much time on propecia help and sure enough he got them .

maybe its just a coincidence but im not so sure.

Not coincidence. I literally think it would be worth studying the side effects of propeciahelp. There was a study a few years back that showed when men were simply told by a doctor that the drug they were taking (finasteride) may cause sexual side effects, 4 times as many of them experienced these symptoms compared to another group who was told the drug caused no symptoms. Imagine the effect of something like propeciahelp, where you read through hundreds of horror stories. You're setting yourself up for disaster, guaranteed. I've seen it happen to a dozen people on this forum.

So many people dismiss this effect as being real. But a very good recent example would be wind farm sickness. Hundreds if not thousands of people were complaining about severe illnesses such as hypertension, insomnia, depression, anxiety, etc. but a recent study uncovered the fact that it was all a result of propaganda. The fact that these people were convinced the condition existed actually caused these terrible symptoms to occur. I have no doubt the exact same thing can, and does occur with finasteride. I still believe the drug can cause persistent sexual dysfunction in extremely rare cases, but i'm willing to bet a large percentage of people are experiencing their symptoms from this same 'nocebo' effect. It's proven without a doubt that a bunch of windfarm activists caused it to happen, why would the anti-finasteride group not be able to do the same?

 

[Quantum Cat]

Reminds me of a study into antidepressants that was conducted- half were given real anti-Ds and half were a control group who were told they were taking an anti-D. There were apparently no difference in results between both groups.

Most people in the control group reported that they felt much better and happier, many reporting that their depression had completely lifted after a while of taking the course of medication - even though the 'medication' they were taking was nothing more than a sugar pill. They were given something though: hope. Which is why many felt happier.

It demonstrates the power of the mind and the placebo/nocebo effect.

 

[geeray]

finasteride probably can cause depression and anxiety, but like was mentioned, it's probably only going to happen to people who are at a risk for it anyway. Personally, I dealt with sever anxiety and depression for years in my 20's. I got over it completely a few years before I started finasteride, but I haven't had a recurrence of any depressive symptoms after 2 years on the drug. I figure if anyone is at risk, it would be someone like me. Take that anecdotal story with a grain of salt, but for me personally eases my mind about the whole thing.

I just wanted to counter that slightly with my own experience. Having been on finasteride for over 5 years and experienced little or no side effects, I was hit with a pretty bad period of depression around 6 months ago, that only alleviated after coming off the drug. I had experienced bouts of it in my teens, so was familiar with the symptoms, but I hadn't been affected by it since. Akin to your comment, this is also anecdotal, but I think it's important to realise that even after for long-term users that have been side-free, things can crop up. I'm kind of hoping that it was a 'bad batch' or something, but I doubt that's even possible, as I would like to continue taking it, but i'm still a little cautious. I be talking to my Doctor about it before restarting.