The lost men: how Merck, GSK papered over bad outcomes in trials
A re-examination of clinical trials of finasteride and dutasteride reveals warning signs of long-term harms to surface later.
History & context
The lost men – appendix
A summary of men who had unresolved and severe adverse events in clinical trials of finasteride and dutasteride.
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 or chronic abuse. This post covers post-drug disorders linked to use of alcohol, hallucinogens, antidepressants, benzodiazepenes, isotretinoin (also known … Read more
Men’s fitness influencers are raising alarms about finasteride risks
Fitness influencers are followed primarily by younger men who want to be stronger, better-performing, and in some cases more attractive. This brings up the topic of hair and hair loss. In the era of Instagram, body-hacking and online prescribers such as Hims and Keeps, young men’s worries over hair loss might be greater than ever. … 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.
Elements of a drug safety disaster
Over the past 25 years, finasteride harms have spread invisibly, altering lives and giving rise to confusion and disagreement. This post identifies common themes across all these spheres. Many of these have to do with biases, omissions and collusion among industry, physicians and regulators.
A rundown of new bibliographies & research guides
The research base spans many disciplines and goes back almost 50 years. To help researchers get oriented, an on-ramp was added. In the Systems & functions area, a new bibliography was added: Adverse effects on skin, comprising nine case reports. The gynecomastia bibliography has been expanded. The bibliography on the musculoskeletal system has been expanded … Read more
Rules of engagement: how sensitive concerns are hidden from drug trials
Alan, a 28-year-old man who experiencing hair loss, is participating in the Propecia clinical trial. Alan brings high hopes that the new drug will stop hair loss. An investigator examines Alan’s scalp and hair, recording figures on a form. She asks Alan if he experienced any side effects. None, he replies. He is then given a form to fill out…
Appendix: Results of online polls on side effects
This is an Appendix to the post: Polls vs. official data on side effect rates. Summary Mobile users: swipe left to see more columns. ID & source Date posted Participants % with side effects % with severe or persistent side effects P1. r/tressless Jan 2016 146 53.4% NA P2. r/HairLoss Jul 2021 110 27.3% NA … Read more
Hair or manhood—choose one?
In ancient Greece, Hippocrates and Aristotle observed that eunuchs did not go bald. Jumping ahead to the early 1940s, American anatomist James B. Hamilton reviewed histories of men with testosterone deficiency and found a pattern: the earlier the age of hormone deficiency, the less balding occurred.