Study of depression from prostate drugs loses the signal by including past users

Response to: Hagberg KW, Divan HA, Nickel JC, Jick SS. Risk of incident antidepressant-treated depression associated with use of 5α-reductase inhibitors compared with use of α-blockers in men with benign prostatic hyperplasia: a population-based study using the Clinical Practice Research Datalink. Pharmacotherapy. 2017. doi:10.1002/phar.1925 SUMMARY: Hagberg et al, 2017 fails to assess the risk of … Read more

Study of ED risk loses the signal by including past users of finasteride

There is a major limitation: the analysis included past and recent users of 5ARIs, as well as current users. Past users are defined as those who stopped taking a 5ARI at least 91 days before getting diagnosed or treated for ED. Recent users are those who last took the drug 31-90 days before diagnosis or treatment for ED.

Mind the gaps: remarks on the evidence base

This post makes a few not-so-obvious points about the sprawling literature on finasteride and 5-alpha syndrome. If you are new to this literature, consider starting with a brief history of the research and a guide for researchers. Those pages describe what is in the literature, but it is also important to discern what is not … Read more

2023 – year in review

Fitness influencers and physicians raised alarms about risks of finasteride for hair loss this year, reaching millions of people through tweets, videos and podcasts. On the regulatory front, in France boxed warnings were added to finasteride packaging. Health Canada added a warning about suicidality while the UK regulator launched a safety review. Forty-four relevant research … Read more

Finasteride appears on Prescrire’s latest ‘Drugs to Avoid’ list

Prescrire, an independent patient safety organization based in France, has updated its Drugs to Avoid guide. Finasteride appears in the 2024 edition, and has also been included in past editions. The guide notes: Finasteride 1 mg, a 5-alpha reductase inhibitor, has very modest efficacy in androgenic alopecia in men: it increases hair density on the … Read more

Stanford urologist discusses risks of finasteride on Huberman Lab podcast

On November 6, Dr. Andrew Huberman spoke to guest Dr. Michael Eisenberg, a urologist and professor at Stanford Health Care in California. In one segment, they discussed post-finasteride syndrome.

Temperature check on recent literature

5-alpha syndrome (post-finasteride syndrome) is appearing more regularly in the medical literature. Recent articles show slightly more openness to the syndrome as legitimate, especially in the fields of andrology and sexual medicine. But they continue to recycle old arguments that pin the problem on the patient, such as pre-existing psychological and sexual disorders, a nocebo … Read more

Response to Campbell et al on finasteride-associated suicide and depression in men treated for hypogonadism and impotence

The clear and concerning results in this abstract are statistically significant RORs for suicidal and self-injurious behaviors, anxiety disorders and depressed mood disorders in the finasteride-only group. The suggestion that combination therapy could “decrease” risk or have a “protective” role is unwarranted because the risk ratios are derived from unrelated sets of cases. This study seems to treat pharmacovigilance data as if it were a controlled, prospective study, when the data is uncontrolled and retrospective.