Merck’s former physician-allies sowed doubt while Propecia litigation was pending

After FDA approved finasteride for male hair loss in 1997, the drug’s reputation stayed untarnished for a dozen years in the United States. However, the tide shifted in the 2010s: label warnings were added about risks of depression and lasting sexual dysfunction. Lawsuits about persistent sexual dysfunction were filed against Merck. These were later consolidated … Read more

Medical journals and physicians ignore conflicts of interest after a few years

Physician-researchers known as key opinion leaders have a crucial role in launching a drug into the marketplace. While Propecia litigation was underway in the 2010s, a number of opinion leaders who had helped Merck launch Proscar and Propecia wrote articles defending the drug’s safety.

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

Appendix: response to Trüeb

This appendix accompanies the article: Response to Dr. Ralph Trüeb’s writings on post-finasteride syndrome. Table of competing interests ← back to main article Engagements with Merck re: Propecia Skin Appendage Disorders (journal) (1) International Journal of Trichology (2) Experimental Dermatology (journal) Hair Growth and Disorders textbook (2008) Cited by Trüeb Ralph Trüeb, MD Member, Editorial … Read more

From LSD to Zoloft, drugs can leave lasting damage

SUMMARY: Post-drug disorders are not side effects that linger, but lasting changes that may be severe and irreversible. These disorders are linked to prescribed drugs as well as recreational drugs, and can arise after one dose, long-term use, or abuse. This post covers post-drug disorders linked to use of alcohol, hallucinogens, antidepressants, benzodiazepenes, isotretinoin (also … Read more

Men’s fitness influencers are raising alarms about finasteride risks

Fitness influencers draw in an audience of younger men who want to be stronger, better-performing, and in some cases more attractive. Some guys worry that hair loss will dim their prospects for dating, sex and relationships—or even professional success. In the era of Instagram, body-hacking and telehealth companies such as Hims and Keeps, young men’s … Read more

How Merck buried finasteride’s full impact on hormone signaling

Merck held that finasteride had a simple and selective mechanism. In fact, it disrupts hormonal pathways much more broadly. These pathways support the brain, reproductive system and other organs. Merck’s selective account concealed risks which would surface in the decades after approval of Propecia.