Dr Rassman, if you would do a little more digging, you’d realize that besides inhibiting 5AR2 reduction of Testosterone to DHT, Finasteride also operates as a NEUROSTEROID inhibitor of Allopregnanolone and THDOC synthesis, neurosterois which can then no longer act properly on GABA-A receptors in the brain.
See page 3 for diagram: PDF file at CNS Drug Reviews
Also, from Journal of Neuroscience
â€œThis may have implications on the clinical use of neurosteroid synthesis inhibitors such as finasteride (Propecia), because certain neurological disorders related to steroid hormone changes may be worsened by finasteride treatment (Herzog and Frye, 2003).â€
From Journal of Andrology
Notably, preliminary studies indicate that, as in the rodent, finasteride may increase depression in men as a result of the loss of allopregnanolone (eg, Altomare et al, 2002; Rahimi-Ardabili et al, 2006).
This raises the possibility that lowered levels of the neurosteroid contribute to the reduced sexual desire reported for some patients.â€
Clearly the dermatology community loves to downplay the true sexual, physical and mental health risks of this drug â€” to admit the truth would be financial suicide. The fact is, neurosteroid inhibition via Finasteride can effect one’s mental health, if one is susceptible to such inhibition.
Perhaps you should try the medication yourself for 2 years Dr Rassman, and see how less mentally sharp you becomeâ€¦ in addition to the possibility of altering the androgen/estrogen ratio in favor of estrogens, developing gynecomastia, penile fibrosis due to depleted DHT levels, loss of morning and spontaneus erections, and prostatic involution â€” just for starters.
If you were to experience these issues as many other men have thanks to this drug, I doubt you’d be so dismissive of the effects of androgen deprivation therapy via 5AR inhibition.
I’ve been on Propecia for well over 2 years and I still have the mental capacity to run multiple businesses, develop new tools and techniques, perform surgery, and even write a daily hair loss blog. Not only have I not seen any negative side effects from the medication, but the great majority of my patients that take the medication haven’t reported these side effects to me either. Before I started this site, it was very, very rare that I had read/heard any reports like that. The Internet provides a very big megaphone for those that have problems, real or perceived.
I have posted your opinions and your references. I appreciate the time you took in collecting the sources and quotes. Clearly the readers need to draw their own conclusions.