Propecia (finasteride) and depression?

[MeowMeansMeow]

Hi all,

I just started taking Propecia a few days ago in an initial attempt to stem and perhaps reverse my thinning hair. I've noticed feelings of depression that started very soon after starting the Propecia.

I don't think it's psychosomatic, I haven't changed my thinking at all (i.e. I'm not dwelling on "life" or anything like that), this feels more of a physical thing that is like an almost overwhelming feeling of "blah" in my head. It's not suicidal, but it is kind of like a big wet blanket feeling on my brain that makes me feel tired.

Anybody else get this?

If it is known about as being a possible side effect, does it go away after a while if I keep taking the Propecia (i.e. your body gets used to it)? Or is it something that is not going to go away until I stop taking the drug? Or is it one of those things that's different for everyone? Probably the latter, I'm just wondering what other people have experienced or heard.

I'm also asking because I was thinking about going back to my doc and asking for a prescription for Proscar instead, since it would be covered by my insurance prescriptions, whereas Propecia isn't (probably since it's seen as cosmetic, whereas Proscar is for BPH). I would like to get as much effect out of it as possible, not only for the hair restoration but also for any preliminary anti-androgen effects it might give. Is Proscar good for this?

Thanks,

Meow

[Asfsd4214]

From what I've heard, there can be quite a few "uncommon" side effects relating to mental state and Finasteride.

Depression isn't the worst of them. And I've heard some mixed things about them getting better soon even after stopping the medication.

Scary stuff, I don't want to take it for those reasons.

I've never used it, so I can't really give you any of the facts you want. But doing a google search on propecia side effects you can find an unusually high level of alarming stuff.

[MeowMeansMeow]

Thanks, Ashley! This is the type of "word on the street" that I'm looking for.

So if Propecia gives me this type of negative side effect, maybe I'd be better just using Rogaine (no mental side effects there, hopefully, since it's only applied topically).

Looking ahead a bit to "real" HRT, is anyone aware of similar such side-effects from Spironolactone?

I had a testosterone test recently, before this most recent resurgence of GID, and it came back on the low side of normal. The "free testosterone" was very low, I believe, but total T was low normal. Unfortunately I don't have the numbers here. I was getting tested because I was trying to track down my feelings of depression and general fatigue that I've had for years and years. I read a book about testosterone, and how low levels in males can trigger the types of symptoms I had been experiencing.

In the process of reading around, I found out about Vitamin D, and how most of us are severely deficient in it. It's a most interesting vitamin, more like a steroid hormone really, which apparently affects a whole slew of genes in our bodies. It not only drives bone density, but also boosts our innate immune system. In fact there is one theory that the whole concept of "flu season" is based on a lack of vitamin D in the winter months, due to lack of sunshine. It also protects against many different types of cancer. When I got tested I came out rather low (37, which was after a couple of months of supplementing with 2000IU per day, so I must have been even lower before). More recently another test put me at 54, which is better. You really need to be above 50, as far as I can tell. Well, the reason I'm talking about this is that I think this is the first vitamin that I've tried (and I've tried many, believe me) where I'm actually noticing a real result. I feel better generally, less depressed, and I was able to start on an exercise regime (lost about 10 lbs already). Until the Propecia, I was feeling pretty good. Now not so much. Also, I haven't had any colds or flu this season, whereas normally I'd catch whatever was going around. My wife had a pretty bad cold, but all I got was a slightly dry throat for a couple of days. Color me impressed! If you haven't already, I would go get yourself tested (do the 25-hydroxyvitamin test) and if you're low, start taking about 2000 to 5000 IU per day, and get tested again in a few months to check your blood levels. It's very hard to overdose on vitamin D (your body makes about 20,000 IU in 15 minutes of full sunshine exposure), so it's pretty safe - but get tested before and during anyway, just to be on the safe side. Lots of info on google about it - bottom line, you need much more than the 400 or 800 IU that the government recommends. More like 5000 IU is a good daily dose, as far as I can tell. The good news is that it's usually very cheap at the local health food store.

Sorry to go off on a tangent, but it is related - like I said, up until a few days ago, I was feeling pretty darn good, not depressed, higher energy, I've been working out (running, rowing) and finally losing weight. I put all that down to vitamin D. The propecia seems to be putting a bit of a damper on all that though!

Back to the testosterone thing - if low T gives you feelings of blah (in genetic males), then is there a chance that going on anti-androgens will give a similar result of depression? Does that happen with spiro, and if so does it get better in time or what?

Thanks again,

Meow

[Asfsd4214]

Thanks, Ashley! This is the type of "word on the street" that I'm looking for.

So if Propecia gives me this type of negative side effect, maybe I'd be better just using Rogaine (no mental side effects there, hopefully, since it's only applied topically).

Looking ahead a bit to "real" HRT, is anyone aware of similar such side-effects from Spironolactone?

I've never heard of any of the kinds of side effects I have with finasteride as I have with spiro.

From my admittedly extremely limited knowledge of how these drugs actually work, finiastride blocks something called 5-alpha reductase which is an enzyme that converts testosterone into DHT, which in effect stops DHT induced effects like hair loss. But the enzyme does other conversions of steroids related to neurological function, hence the possible neurological side effects. Depression, mind fog and fatigue are the ones I've heard most described.

Disturbingly, some people have reported that its taken a very very long time for these effects to subside even after stopping finasteride.

Spironolactone on the other hand inhibits aldosterone and binds to androgen receptors preventing androgens like testosterone from having an effect in the body.

It doesn't inhibit the same thing finistaride does as part of its anti-androgenic effect, and I haven't heard of anything like the same side effects with spiro. In fact it's probably one of the safest of relatively potent anti-androgenic drugs.

I had a testosterone test recently, before this most recent resurgence of GID, and it came back on the low side of normal. The "free testosterone" was very low, I believe, but total T was low normal. Unfortunately I don't have the numbers here. I was getting tested because I was trying to track down my feelings of depression and general fatigue that I've had for years and years. I read a book about testosterone, and how low levels in males can trigger the types of symptoms I had been experiencing.

In the process of reading around, I found out about Vitamin D, and how most of us are severely deficient in it. It's a most interesting vitamin, more like a steroid hormone really, which apparently affects a whole slew of genes in our bodies. It not only drives bone density, but also boosts our innate immune system. In fact there is one theory that the whole concept of "flu season" is based on a lack of vitamin D in the winter months, due to lack of sunshine. It also protects against many different types of cancer. When I got tested I came out rather low (37, which was after a couple of months of supplementing with 2000IU per day, so I must have been even lower before). More recently another test put me at 54, which is better. You really need to be above 50, as far as I can tell. Well, the reason I'm talking about this is that I think this is the first vitamin that I've tried (and I've tried many, believe me) where I'm actually noticing a real result. I feel better generally, less depressed, and I was able to start on an exercise regime (lost about 10 lbs already). Until the Propecia, I was feeling pretty good. Now not so much. Also, I haven't had any colds or flu this season, whereas normally I'd catch whatever was going around. My wife had a pretty bad cold, but all I got was a slightly dry throat for a couple of days. Color me impressed! If you haven't already, I would go get yourself tested (do the 25-hydroxyvitamin test) and if you're low, start taking about 2000 to 5000 IU per day, and get tested again in a few months to check your blood levels. It's very hard to overdose on vitamin D (your body makes about 20,000 IU in 15 minutes of full sunshine exposure), so it's pretty safe - but get tested before and during anyway, just to be on the safe side. Lots of info on google about it - bottom line, you need much more than the 400 or 800 IU that the government recommends. More like 5000 IU is a good daily dose, as far as I can tell. The good news is that it's usually very cheap at the local health food store.

Sorry to go off on a tangent, but it is related - like I said, up until a few days ago, I was feeling pretty darn good, not depressed, higher energy, I've been working out (running, rowing) and finally losing weight. I put all that down to vitamin D. The propecia seems to be putting a bit of a damper on all that though!

Back to the testosterone thing - if low T gives you feelings of blah (in genetic males), then is there a chance that going on anti-androgens will give a similar result of depression? Does that happen with spiro, and if so does it get better in time or what?

Thanks again,

Meow

As far as I know (but again, what DO I know?  ) It doesn't matter too much what your genetics are as far as what your hormonal influences will be at the same levels as someone else as far as getting a completely different reaction because you're XY and not XX.

Something to keep in mind is that males with a low testosterone level, are only abnormal in the sense that that's not what their hormonal levels should be, but they're still very different from a female hormone levels, which would include estrogen and progesterone. The body needs sex hormones to function properly, if it doesn't have the right levels for at least one sex or the other, you'll have negative side effects.

In short, I don't think spiro or low androgen levels is likely to cause depression if your supplemented with estrogens as well. At least it hasn't for me. 


Oh and about Vit D, I take it too. But only because of another fun fact about Vit D, deficiency in it is also related in some ways to multiple sclerosis. Seems like deficiency in Vit D is just generally a pretty bad thing.

[MeowMeansMeow]

Right, I'm going to stop the Propecia today and see what happens... hopefully since it's only been a few days, I won't see any long term side effects. Good to know, thanks again! Anybody else with similar experiences?

Meow.

[Hannah]

5-alpha reductase which is an enzyme that converts testosterone into DHT, which in effect stops DHT induced effects like hair loss. But the enzyme does other conversions of steroids related to neurological function, hence the possible neurological side effects. Depression, mind fog and fatigue are the ones I've heard most described.

I would be interested in reading more about this, could you link or pm me the research?  Particularly which steroids and presumably neurotransmitters DHT enables. DHT inhibitors are excellent tools for androgen suppression, and I personally would be hard pressed to let go of my dutasteride. I'd rather take Avodart and Celexa (an antidepressant) every day than not take Avodart at all...but I'd really like to read through that research because genetic women don't have circulating dht levels nearly as high as genetic men and they aren't always horribly depressed, and I'm intrigued about why and if we will eventually develop these mechanisms as our brains morph and adapt to the feminine hormone environment.

[Asfsd4214]

I would be interested in reading more about this, could you link or pm me the research?  Particularly which steroids and presumably neurotransmitters DHT enables. DHT inhibitors are excellent tools for androgen suppression, and I personally would be hard pressed to let go of my dutasteride. I'd rather take Avodart and Celexa (an antidepressant) every day than not take Avodart at all...but I'd really like to read through that research because genetic women don't have circulating dht levels nearly as high as genetic men and they aren't always horribly depressed, and I'm intrigued about why and if we will eventually develop these mechanisms as our brains morph and adapt to the feminine hormone environment.

As far as I know, it's not the absence of DHT that's the problem, it's that finistride blocks the formation of DHT by inhibiting the 5AR enzyme (Dutastride does too if memory serves), and that enzyme does more than just form DHT from T. It also converts other steroids into substances important to neurological functioning.

Basically it's a side effect, in the truest sense of the term. In blocking DHT in blocks a few other more important things as well.

http://www.bio.net/bionet/mm/neur-sci/2004-August/058929.html

Some VERY complicated explanations can be found in the above link.

5 alpha reductase (5AR) is an enzyme which comes in two forms, type I
and type II.  It not only converts testosterone (T) to
dihydrotestosterone (DHT, a ketone), it also converts progesterone to
allopregnanolone and deoxycorticosterone (DOC) to tetrahydroDOC (THDOC),
both allosteric enhancers of the GABA(a) receptor (e.g., they increase
the effectiveness of inhibition signals relayed along GABA channels in
nerves).  The second stage of this conversion is performed by
3alpha-hydroxysteroid oxidoreductase.

...


Finasteride is a 5AR type II inhibitor which
reduces DHT levels by up to 70%.  Dutasteride inhibits both type I and
type II 5AR achieving a reduction of up to 94% of DHT.  Type I is the
only 5AR expressed in the brain.  Its long term inhibition was never
studied when dutasteride was approved by the FDA.  Blocking DHT
synthesis in the brain like this also blocks allopregnanolone production
there.  While other tissues like bone also express 5AR, finasteride has
been specifically studied on bone growth and has had no effect.  Will
this also be true for neurodegenerative disorders which take decades to
develop?  Will 5AR inhibitors be safe for individuals with epilepsy,
TMJ, neuropathy, alcoholism, tinnitus, metals poisoning or other
GABAergic illnesses?

If it's true that dramatic 5AR inhibition contributes to long term
neurodegeneration then what other therapeutic agents are available for
dealing with excessive DHT?

Other information can be found here

http://www.biomedcentral.com/1472-6904/6/7

This preliminary study suggests that finasteride might induce depressive symptoms; therefore this medication should be prescribed cautiously for patients with high risk of depression. It seems that further studies would be necessary to determine behavioral effects of this medication in higher doses and in more susceptible patients.

Also you only need to do a google search on propecia to see the relatively impressive amount of negative reports by men using it for hair loss.

Now granted, not EVERYONE reports any serious side effects, and some of those that do only do so after 5-10 years of taking it. But given the severity of the reported side effects, and that in some cases there seems to be some difficulty in recovering from them even after discontinuing finistride, I wouldn't take it unless there were no alternative.

[Hannah]

*sigh*

It kind of makes me sad that I understood every word of that  Too much college and not enough partying in the desert with friends, meh.

Thank you Ashley, that got me rather nicely started.

[stephb]

I have been taking Procar for several months now and have not experienced any negative side effects, other than reduced libido. Since it is supposed to take 6-12 months to see even the positive effects, I would be surprised to see negative side effects after only a few days. If anything, I have felt less depression and discouragement just because I know that I am taking some action that will reduce the effects of T.

Steph

[MeowMeansMeow]

I had taken six of the Propecia (one per day) and started noticing the heavy depression feelings very quickly - I didn't take notes, but I think it was within a couple of days. Last one was on Saturday, and I'm feeling a little better already now.  This is interesting because back in 2001 I had a short tryout with hormones (ordered online from New Zealand), Estraderm and Propecia, and I had the same type of negative reaction very quickly then too. I checked my diary last night, and at the time I was thinking it was the Estraderm that was the problem for some reason (maybe I saw more significance in estrogen, the female hormone, than Propecia, something for stopping hair loss, I dunno). Anyway, I stopped both back then fairly quickly because of the mental "wet blanket" feeling it produced. The other funny thing is that I stopped thinking about transition after that for a long while, in part because of the (seemingly) chemically induced depression and partly because I concluded that hormones just "didn't agree with me" or something.

Here's the really interesting thing: My GID feelings have receded somewhat these last few days too. With the onset of the depressive feelings, the GID is less. Now my recent resurgence of GID seemed to occur just as I was starting to feel better, physically and mentally, after taking vitamin D and starting to exercise properly again. So the implication is that feeling good and healthy brings on and accentuates the GID feelings, whereas depression lessens it. I'm not sure what that means, if anything, but it's interesting. I'll bring it up with the therapist tomorrow...

My, what a chemical soup we are.



Meow

[Naturally Blonde]

I didn't feel any depression after taking finesteride but I also didn't get any benefits from it either!

[MeowMeansMeow]

The somewhat debilitating depression has continued even after discontinuing the Propecia last Saturday. I was only on it for six days total, but it seems to have had a fairly heavy effect on me. I read this page today on the possible effects of Propecia:

http://www.hairloss-research.org/UpdatePropeciaandDepression7-08.html

Based on this, I am going to try taking a Pregnenolone supplement, starting at 25mg per day, to see if it affects the symptoms at all. I'll update this thread with the results.

Interesting that my GID has lessened so much with the onset of these symptoms (which I am very sure was caused by the Propecia - while I do have a tendency to brood and fret over things, this is completely different - it's like a chemical blanket of darkness, fatigue and general "blah" that has been lowered onto my brain). I am finding it difficult to work or even think straight right now, let alone ponder gender identity issues. I'm really hoping this goes away soon. No suicidal feelings, but I did just go to sleep for 3 hours yesterday afternoon. Feeling like crap, basically.

Meow

[Hannah]

Please do keep us updated on the supplement.

I had a thought the other day about this when I asked my new psychiatrist about Ambien. At home, it hasn't been working as well and has had WAY more side effects than it did in the hospital. Well, at home I take generic Zolpidem, the hospital was using name brand. According to him, sometimes there's a difference.

That makes me wonder if maybe you should try Fincar or Dutas, the generic versions of Propecia and Avodart. They are the same drugs as the name brands, just made differently. I dunno, it's just an idea.

Do you know what your dht level is?

[MeowMeansMeow]

Hi Becca,

No, I don't know what my DHT level is. Perhaps I should get it tested, thanks for the idea.

I am not going near anything that is even remotely akin to Propecia in the near future, sorry... I've been badly burned by this, it's really screwing with my head (I feel like I've been heavily drugged and want to go to sleep and/or burst into tears all the time). My first priority is to recover from this thing before trying other experiments. The pregnenolone seems like a reasonable thing to try here, since it apparently kind of has the opposite effect from the finasteride, so I'm hoping it'll balance things out a bit. But thanks for the advice! I will update here as and if I see any changes.

Meow

Thinking about changing my sig to Chumbawamba:
"I get knocked down, but I get up again, you're never gonna keep me down"

[Hannah]

Possible Pregenenolone Side Effects:
Pregenelone supplement use may lead to side effects which include overstimulation and insomnia, irritability, anger or anxiety, acne, headache, possible scalp hair loss if used daily for prolonged periods. Pregnenolone converts into DHEA, which in turn converts into testosterone and possibly on to DHT

Might pay off to get it checked before and after the supplementation to see if this is in fact occurring. It looks like it's gonna bring your dht up, which is what you were trying to get down in first place.

I wonder. You know, I've read about spiro paste being applied directly to the scalp. That might be worth asking the doc about when your'e getting the blood draw.

[Eva Marie]

I never noticed a thing while I was taking propecia (except some boobage growth  ), and a little less hair loss. Now i've switched to dutas, which seems to do more for hair loss than propecia did, judging from the view of the back of my head. I was also taking a much smaller dose of propecia than you were; I was taking the normal recommended daily dose of it for hair loss.

I also take st. johns wart for depression, and maybe that offset any depression effects that propecia was doing 

[MeowMeansMeow]

I was also taking a much smaller dose of propecia than you were; I was taking the normal recommended daily dose of it for hair loss.

I was taking the regular dose for hair loss of 1mg per day.

Obviously these things affect everybody differently...

Meow

[Naturally Blonde]

I was taking the regular dose for hair loss of 1mg per day.

Obviously these things affect everybody differently...

Meow

I tried it to see if it would help with the very slight widows peak I had with my hairline but it didn't do anything at all.

[MeowMeansMeow]

I feel a little better today after taking some of the pregnenolone. I woke up feeling energised and really pretty ok. I don't know if it would have happened anyway, or if it is the placebo effect, or whatever, but for whatever reason I don't feel this incredible heavy blanket of mental fatigue and depression as much today. I'll take the pregnenolone for a few days and see what happens, then stop and see if the depression returns or not (it's not completely gone, just not quite as debilitating today).

These drugs are scary things. They can really mess with your head.

Meow


mod edit: dosages removed

[Laura91]

Finasteride is an evil drug and I would have never taken it had I known that it would have affected me in the way that it did. I was constantly depressed and spent a LOT of time thinking about suicide while on finasteride. Once I stopped taking it all of that stuff stopped.