Category: Drugs

Snippet from the article:

When it comes to taking medicine, you may get what you expect.

A new study has found that your expectations can affect how well pain medications work. Being optimistic may boost their effectiveness in blocking pain, while being pessimistic may lower their effectiveness.

Unlike earlier research, the new study used brain imaging techniques to examine brain regions that are known to be associated with pain. Scientists say that until now, little research has been done to clarify the brain mechanisms that control how different expectations affect drugs.

Read the full story — Positive Thinking May Make Drugs Work Better

This is a very interesting article. Pessimism may lower effectiveness, wishful thinking may make the drug work. We’ve talked about this before on the blog, and this is something many of my colleagues have expressed. When physicians prescribe a medication to patients who are obsessed or too worried about side effects, they usually seem to get the side effects. It’s almost a self-fulfilling prophecy.

I’ve been taking Propecia/finasteride for going on 10 years now (started when 23). I am very pleased with my results, including hair REgrowth on dome and even in front.

My question is, how long can I anticipate this will continue to work and should I have any concerns about taking this drug for so many years now and into the future? I have not experienced any known side effects.

I am glad you’ve had good results with Propecia with no side effects in the last ten years you have been taking it. Unfortunately, I cannot predict the future. I have no basis of your own personal progress. I do not have a set of measurement points so that I can even take an educated guess. This is one of the reasons why we remind folks to follow up with their doctor. Hopefully if one doctor has been following your progress, there should be some sort of documentation or some objective measurements that they can refer to give you a better answer. Generally speaking, some patients report their visual benefits decrease after around 5 or 6 years, but I’ve got some patients taking it for over a dozen years with excellent results. Each person is different.

We suggest that all men taking finasteride get a bulk measurement baseline to help quantify when the drug may be starting to show less benefits. Bulk measurement will tell you much and if you do it every year, then you can clearly see a trend if it is starting.

As for safety… well, Propecia is a safe medication and I don’t think you should be concerned about the long term use. It’s worth noting that finasteride (in a larger 5mg dose) has been on the market for nearly 20 years now.

Hello,
I have used Minoxidil 5% with good results for 2 years. In the first year I used a solution with ethanol and retinoic acid but switched to ethanol retinoic-free minoxidil 5% after a year.

1. Are these agents vitally important to the work of minoxidil?
2. My hair seems to go in cycles from quite thick to quite thin and back again over 6 months or so.
3. is this normal with minoxidil use?

Many thanks

1. Retinoic acid produces a mild burn to the skin which increases blood supply and the absorption of minoxidil. That is why, I believe, some doctors use retinoic acid, though it isn’t necessary for minoxidil to show benefits. Ethanol (alcohol) is an ingredient in Rogaine and I’d assume most topical minoxidil products.
2. Some patients have reported hair cycling by time of year. It seems to be rarely talked about, so I really do not know the answer to question #2.
3. Cycling occurs with or without minoxidil use, but this is the normal hair cycle — anagen, catagen, and telogen. I’ve previously written about hair cycles.

Hello,

I just wanted to let you know that Wal-Mart has added Finasteride 5mg to their discounted generics program, they charge only $9 for 30, 5mg tablets. I just thought that your readers might find this information helpful…

Yes, I’m sure many readers are very pleased to learn about this info. Thanks for sharing!

That pricing is on par with what Target charges for generic 5mg finasteride.

I was watching TV last night and saw a commercial for a depression medication called Abilify (aripiprazole). I often treat and see patients on anti-depressant medications and it is a great benefit for them (for treating their depression). What struck me about the TV commercial was the lengthy side effect warnings, including stroke, high fever, muscle rigidity, high blood sugar, higher risk of infection, etc. These side effects are very rare, and many other anti-depressant medications have very similar possible side effects.

Then I turned on my computer to look up the common side effect of a popular erectile dysfunction medication most of you probably heard of: Viagra (sildenafil). Some reported and documented side effects include blindness, heart attack, hearing loss, etc.

Which brings me to the controversy of Propecia (finasteride) and its negative sexual side effects. I acknowledge there are websites devoted to the unreported side effects of Propecia (as well as other medications) and that there are men who are experiencing something. I really cannot say if what they are experiencing is due to Propecia, but for the sake of argument, let’s give them the benefit of doubt. I think we can all agree the chances of getting these side effects are relatively low. From personal experience in treating thousands of patients for over 10+ years I personally have not seen any permanent side effects associated with Propecia, and about 1 to 2% of men do experience negative sexual side effects (which have been all reversible). Again, this is from my personal experience among thousands of patients I have seen.

My point is this: ALL MEDICATIONS HAVE SIDE EFFECTS. You must understand this and discuss the benefits as well as the risks with your doctor and make an educated and informed decision. Millions of people use Viagra knowing that they can go blind or have hearing loss… but the risk of this happening is extremely low! If you believe the extreme side effects associated with Propecia, it is your choice not to take it. To some, sex may be more important than their vision or hearing. And to others, hair is more important than their sexual activities. Of note, I can say that I have prescribed Viagra to men who are taking Propecia and they still have their hair, sight, and hearing.

I tried taking Proscar, cut into quarters, for 3 months and at the three month mark quit as I felt I was experiencing side effects (frequency of erections dropped drastically, morning wood gone, very difficult to maintain an erection, etc.) After quitting, within approximately 2 weeks I felt that sexual functions were back to normal. I had done tons of research prior to taking it, and was very worried about sexual side effects, and cannot rule out the possibility that the side effects were psychological in nature; however, the lack of morning wood I felt to be pretty significant.

I can’t get the idea of trying it one more time for a little longer than 3 months out of my mind. If I were to try it again, would you recommend sticking with 1/4 a pill a day, or do you think I could get by with taking 1/4 a pill every other day or just on Monday, Wednesday, Friday?

It does not sound like your erections have been “tested in the field”. Just the absence of morning erections does not fit the “field test”. The libido issues certainly could’ve been prompted from psyching yourself up about side effects, but it would be impossible for me to say one way or the other. I don’t know how old you are or anything about your medical history, but there’s some info at WebMD that you might find interesting.

In general, you can try a lower daily dose to see if that helps, but you need to discuss this with your prescribing doctor.