Category: Drugs

Hello Dr,
I wanted to know if it is safe to take propecia with the antidepressants abilify and celexa?

Always check with your prescribing doctor for questions like this. Generally, the antidepressants do not cause a problem with Propecia.

hey doctor, amazing blog helping a lot of people…
i’ve been on propecia for a 14 months with min to no result. i’m 24 now. i had no problem staying on the drug and give it another 8 months since i didn’t experience any side effect hoping to see better results, until i read about post-finasteride syndrome and it had me worried. so just needed a clear answer from you doctor before considering stopping the drug. is post-finasteride syndrome a real thing?

thank you doctor

This “Post-Finasteride Syndrome” suggests that there are persistent sexual, neurological, and physical side effects for some men when they stop taking the medication (Propecia). It sounds like it’s just a fancy name to wrap around the seemingly endless list of side effects that people on the internet are attributing to finasteride. The data that is available and the information I have from my own patients doesn’t sync up with the reports on the anonymous message boards.

Much of this seems to have stemmed from the hysteria created about a year ago based on a couple of published articles about men that were recruited from a Propecia complaint forum that were interviewed about their side effects. If it sounds ridiculously biased to you, then we agree.

If I am to understand this “Post-Finasteride Syndrome” correctly, it is for those that had side effects, stopped the medication, yet the side effects persisted. If you don’t have any side effects, I don’t think this applies to you. If you want to learn more about this, here is the other side of the coin — PFS Foundation.

I’m 20 years old and considering quitting finasteride after 15 months as I’ve seen no effect at all, but I’ve read finasteride can make you more sensitive to dht. Is this true? By quitting will I be more susceptible to dht than I was before taking it, or will it down regulate aftertime. Many thanks.

You will not be more sensitive to DHT, but you will lose all of the benefits of the drug if you stop it. Even though you say you’ve had no positive effects, it is possible that the medication at least slowed the rate of your loss. After you stop taking finasteride you may see hair loss which would have reflected the hair you would have lost 15 months ago had you not taken the drug in the first place (which I refer to as “catch-up” hair loss).

I respect the fact that you advise using the medications first and clearly state the benefits of using Propecia. If I would not have read your blog I would have just tried Rogaine per my dermatologist. The information is just not out there to use this kinda of treatment / prevention. I was shocked to see some of the great results people have using this as a treatment alone. All you see or hear are the terrible things. I had no idea the drug even regrew hair for most people. Especially for men like me who are 30 with minimal thinning.

Anyway, I was scared to death to take this medicine. I am sure some people have had problems. People also have problems with cars, smoking, and beef. I am close to 90 days on treatment thus far and couldnt tell I have even taken it. The only side I have is feeling alot less stressed knowing I am at least on the proper medicine.

I think your blog is important and I truly believe there is so much misinformation online. Growing older and having some degree of hair loss is normal. I just had my hair cut this morning. I was again told I have tons of hair and this is all in my mind. Granted I dont have the same hair I did when I was 16. Men freak out.., I of course am one of them.

The absolute worst thing I have ever done for myself was trolling the internet. I cant believe I read and re-read these internet forums ( I am sure you are aware of the sites), where people talk about their experiences on these drugs and experimental treatments. I should have known that people who have great results on these drugs certainly do not write about it on hair loss forums. Lets me honest, have you ever had a great steak then written an online review of the place that cooked it? Its few and far between. Propecia is not a silver bullet. However, it is FDA approved and has undergone a battery of clinical tests over several years.

My main point here is, yes people need to do their due diligence in taking medicine. You would not buy a car without test driving it. No one writes anything positive. But be certain, if you have a bad experience you will tell everyone.

Thanks for your frank opinions. We have published many comments and some photos of people who have received wonderful benefits from Propecia over the years; however, seemingly just like on the TV news, you mostly only hear the bad news. The good news isn’t reported very often, because bad news sells and grabs the attention of the audience.

Your comment about reviewing a great steak is spot on. If your food wasn’t prepared to your satisfaction, you’re probably more likely to let people know how dissatisfied you are. As I’ve written before, those that feel wronged by something are generally the most vocal. Everyone else will just continue to live their lives.

Hello doctor.

I have been using minoxidil 5% topical solution for a while now, and have always had this question on my mind. When I apply it, should I just get the substance spread out on my scalp and be done there, or should I actually rub the substance in thoroughly afterwards?

Thanks in advance, I am looking forward to hearing back from you.

A good application to the scalp is enough to get the benefits of minoxidil. Massage it gently into the scalp, but keep in mind that rubbing excessively could pull out the weak hairs on your head.

I am 41 years old and have been on finasteride 1.25 mg daily for 10 years. My father had prostate cancer in his late 60s and I wish to get the PSA antigen test but hear the finasteride drug obscures the results. How is it evaluated the PSA score when on this drug?

Thanks

For those unaware, a prostate-specific antigen (PSA) test measures the enzyme levels of the prostate. Elevated PSA levels can point to prostate cancer. The results of a PSA test for men taking Propecia can result in a decreased level of PSA. At 41 years old, prostate cancer is very rare, but getting a good baseline while you are on Propecia is a good idea as any increase in the years to come might well be an indicator for prostate cancer.

If you’re thinking about having a prostate cancer screening done, you should tell your doctor that you’re on finasteride so that they can double your PSA score.

I’m a 23 year old male with mild hair loss. I started taking finasteride 12 months ago (1.25 mg from generic proscar pills) and have not particularly noticed any benefits or side effects. I knew when I started taking it that gynecomastia was a possible side effect, but I have had gynecomastia since I was 13 so it didn’t concern me. Soon I will be getting surgery to correct that and my surgeon told me that I should discontinue taking finasteride. I definitely don’t want to undo a $4,000 surgery but I was under the impression that those sorts of side effects are pretty rare and if they did happen, usually go away with discontinued use.

Does having had gynecomastia make it more likely that it will return if I continue using finasteride? Since it doesn’t seemed to have done a whole lot does it make sense to even risk it, or should I just switch to rogaine?

If you did not notice any change in your gynecomastia for the past 12 months on finasteride, then I would assume that your breast tissue is not finasteride sensitive. That said, in the face of your doctor’s recommendation, I am at a loss. You should usually follow the advice of your doctor, but in this particular case, it might be something you also talk to your prescribing doctor about (assuming your gynecomastia surgeon and your hair loss doctor are different).

I don’t know that if finasteride would nullify the surgery completely or at all.

I have been taking minoxidil for hairloss! Also I have been taking an aphrodisiac to spice my sex life up! Unfortunately the aphrodisiac does not seem to be working. Could this be due to using minoxidil?

How would you expect me to give you an opinion on an unnamed aphrodisiac? And what led you to link minoxidil to an aphrodisiac?

Minoxidil is a blood pressure reducer (very weak) and it has hair growth as a side effect, but I don’t know it would have an effect on your mystery aphrodisiac. Perhaps the aphrodisiac wasn’t what it claimed to be. Try eating oysters.