Those who have lasting dysfunctions after taking finasteride or dutasteride are not the only ones whose lives have been altered for the worse because of a medical treatment. This post summarizes diseases and conditions that may arise from medical treatments in dermatology, psychiatry, surgery, radiology and general medicine.
Every treatment has been approved by FDA—although some have had warnings and restrictions added after initial approval (e.g., isotretinoin and fluoroquinolones). Many doctors believe they are safe and effective, and some patients have found them effective and tolerable. The safety of some treatments remains a subject of debate among doctors and researchers.
This website does not take an absolutist position against these treatments; rather, it advocates for:
- informed consent of the patient;
- medical advice in the best interest of the patient and free of industry influence;
- respect for the dignity of the patient; and
- research free of industry influence.
Common threads
Although these treatments have different mechanisms and treat different conditions, there are many commonalities in the experience of those harmed by them, including:
Prior to treatment:
- Lack of informed consent: patients were not fully informed of the risks of treatment before it was offered;
- Inflated expectations due to physician advice and marketing;
- Incomplete or unavailable information about harms.
During and after treatment:
- Denial, discounting or deflection of adverse effects when reported. Contributing factors include preference for official medical knowledge over individual experience; physician distaste for uncertainty; and fear of liability. Some physicians will readily toss unwelcome complaints into the wastebasket of “psychological problems.”
- Lack of awareness of new regulatory warnings or product recalls;
- Loss of trust in medicine; demoralization; isolation.
Systemic problems:
- Biases in clinical trials and medical literature, including publication bias and investigator bias in detection and characterization of adverse effects;
- Lack of funding for research on treatment-emergent diseases and conditions;
- Gaps in regulation of medical devices (see 2011 IOM report).
Treatment-emergent (iatrogenic) diseases & conditions
CONDITIONS BY SPECIALTY & TREATMENT
- Dermatology & cosmetic surgery
- Finasteride or dutasteride
- Liposuction
- Cryolipolysis (CoolSculpting)
- Breast implants
- Isotretinoin (Accutane or Roaccutane)
- Topical steroids
- Psychiatry
- SSRI/SNRI antidepressants
- Benzodiazepines
- Antipsychotics
- Transcranial magnetic stimulation (TMS)
- Electroconvulsive therapy (ECT)
- General medicine
- Fluoroquinolones
- Surgery
- Nasal surgery
- LASIK eye surgery
- Mesh implant
- Radiology
- Contrast-enhanced MRI or MRA scans
Dermatology & cosmetic surgery
Finasteride or dutasteride for hair loss
May result in: Lasting dysfunctions in sexual, neuropsychiatric, cognitive and other domains
Resources:
- PFS Foundation
- PFS Network
- This website: finasterideinfo.org
Liposuction
May result in: Visceral fat deposits; embolism; infection; loss of body contours; death
Resources:
Cryolipolysis; branded CoolSculpting with Zeltiq device
May result in: Paradoxical adipose hyperplasia (PAH)
Resources:
Breast implants
May result in:
- Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL)
- Systemic symptoms including joint pain, muscle aches, confusion, chronic fatigue & autoimmune diseases
Resources:
Isotretinoin for acne
May result in: Lasting sexual dysfunction
Resources
Topical steroids
May result in: Topical steroid withdrawal, a “debilitating skin condition which can occur after the termination of topical steroid use, after a period of frequent and/or prolonged use.” –Scratch That
Resources
- Brookes et al., 2023: Topical steroid withdrawal: an emerging clinical problem
- Website: Scratch That – Topical Steroid Withdrawal awareness & information
- BBC story: Steroid cream: Women send out warning after severe reactions
- Video: An Overview of TSW (Topical Steroid Withdrawal) [37:40]
Psychiatry
SSRI/SNRI antidepressants
May result in: Antidepressant withdrawal syndrome or post-SSRI sexual dysfunction (PSSD)
Resources
- Withdrawal syndrome
- UK NHS: Stopping or coming off antidepressants
- Fornaro et al., 2023: Antidepressant discontinuation syndrome: A state-of-the-art clinical review
- PSSD
- Reisman, 2020: Post-SSRI sexual dysfunction
- Bala et al., 2018: Post-SSRI Sexual Dysfunction: A Literature Review
- PSSD Network
Benzodiazepines for anxiety, insomnia, seizures & other conditions
May result in: benzodiazepine withdrawal and benzodiazepine-induced neurological dysfunction (BIND)
Resources
Transcranial magnetic stimulation (TMS) for depression
May result in: Significantly worsening depression and anxiety; cognitive impairment; irritability; fatigue
Resources
- Can Transcranial Magnetic Stimulation (TMS) Hurt You?
- TMS side effects website
- VTAG group on Facebook
Electroconvulsive therapy (ECT) for major depression
May result in: Permanent memory loss and cognitive impairment
Resources
- Kolar, 2017: Current status of ECT
- BMJ Head to Head, 2019: Should we stop using electroconvulsive therapy?
- Read et al., 2021: Electroconvulsive therapy for depression: a review…
General medicine
Fluoroquinolones for infections
May result in: Fluoroquinolone toxicity which may include:
- Disturbances in attention, disorientation, agitation, nervousness, memory impairment and delirium
- Hypoglycemic coma
- Disabling and potentially permanent side effects involving tendons, muscles, joints, nerves and the central nervous system
Resources
- FDA news release (2018): FDA updates warnings for fluoroquinolone antibiotics on risks of mental health and low blood sugar adverse reactions
- Expert Opinion on Drug Safety: An evaluation of reports of ciprofloxacin, levofloxacin, and moxifloxacin-association neuropsychiatric toxicities
- Consumer Reports: Fluoroquinolones Are Too Risky for Common Infections
Surgery
Nasal surgery
May result in: Empty Nose Syndrome, “an iatrogenic, post-operative illness resulting from surgical insult to the nasal turbinates.” –@ENS_Awareness
“The most common complaint…is the sensation of decreased nasal airflow… [A] lack of nasal resistance, makes the nose feel too open. Other symptoms include nasal and throat dryness, nasal burning and crusting. Patients may experience a sense of suffocation. Most ENS patients experience anxiety, depression, and poor sleep quality. The psychological impacts reduce effectiveness, both at work and in daily life.” –American Rhinological Society
Resources
- American Rhinological Society: Empty Nose Syndrome
- Twitter: @ENS_Awareness
LASIK eye surgery
Complications may include: Night vision problems, dry eyes, depression and suicide, eye pain, corneal neuropathy, ectasia (“keratoconus”), late flap dislocation, flap complications, floaters and vitreoretinal damage, infection and other symptoms (Source: LASIK Complications website)
Resources
Mesh implant for stress urinary incontinence, pelvic organ prolapse and hernia
Complications of mesh implants may include: pain, erosion, voiding dysfunction, infection, recurrent urinary tract infections, fistulae, organ perforation, bleeding, vaginal scarring, neuromuscular alterations, lower urinary tract symptoms, bowel complications and immune disorders. (Adapted from Reyes & Hashim, 2020)
Resources
Radiology
Contrast-enhanced MRI or MRA scans
May result in: Gadolinium toxicity, inducing nephrogenic systemic fibrosis (NSF), a “potentially disabling and lethal disease” (Blomqvist et al, 2022)
Symptoms:
- Itchy, red bumps on arms and legs, as well as the torso
- Joint pain that can become disabling
- Hardening and thickening of the skin especially over the arms, legs and trunk
- Progression of fibrosis with deposits in the muscles, lungs, esophagus and heart that damage these organs
- This condition can be fatal.
(Symptoms adapted from Cleveland Clinic page on NSF)
Resources
- Blomqvist et al, 2022
- Sousa et al, 2022
- Nephrogenic Systemic Fibrosis – Cleveland Clinic
- Gadolinium Toxicity (website)
Further reading
Steel K, Gertman PM, Crescenzi C, Anderson J. Iatrogenic illness on a general medical service at a university hospital. N Engl J Med. 1981. doi:10.1056/NEJM198103123041104 • PubMed