Talk:Finasteride/Archive 8

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Post finasteride syndrome

I strongly feel like this section is outdated and uses low quality evidence.

Since this year there are diagnostic criteria for PFS published in "International Journal of Risk & Safety in Medicine" https://content.iospress.com/articles/international-journal-of-risk-and-safety-in-medicine/jrs210023. This should be mentioned along with an outline of those criteria.

Other than that there are at least two papers that discuss a possible epigenetic pathomenachism:

"Altered methylation pattern of the SRD5A2 gene in the cerebrospinal fluid of post-finasteride patients: a pilot study" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6652249/ Conclusion: "For the first time, we demonstrate a tissue-specific methylation pattern of SRD5A2 promoter in PFS patients. Although we cannot conclude whether this pattern is prenatally established or induced by finasteride treatment, it could represent an important mechanism of neuroactive steroid levels and behavioural disturbances previously described in PFS."

Epigenetic Effects of Finasteride on Human Leydig Cells https://faseb.onlinelibrary.wiley.com/doi/abs/10.1096/fasebj.2020.34.s1.03823

This should at least be mentioned.

Other than that there is one part in the current article that needs to be removed: "It has common features with other self-diagnosed "mystery syndromes"[55] such as morgellons syndrome or multiple chemical sensitivity.[15]"

1. It is quoted incorrectly. In the cited source you cannot find this quote word by word. This is where it was taken from, but it is edited: "In our opinion, PFS demonstrates some analogies to such controversial “mystery syndromes” as amalgam illness, multiple chemical sensitivity, Morgellons disease, and Koro for the following reasons: patients complain of symptoms that cannot be adequately explained biologically, and the frequency of consultations for the conditions parallels the respective media coverage, which points to a high degree of suggestibility."

2. As it is made clear in the source this is a personal opinion of the authors.

3. There is no evidence in the source to back up this opinion.

4. The only reason given for that opinion is the reason that there is no known biological explanation. Jumping from the lack of knowledge to a conclusion is a mockery of evidenced based medicine. Moreover there are attempts to explain the syndrome (see epigenetic changes I mentioned before).

5. The source is low quality "evidence" at best. It is a single case report (https://en.wikipedia.org/wiki/Wikipedia:Identifying_reliable_sources_(medicine)) about a patient of the authors, which they use as the basis for really bold claims that are entirely unsupported.

Franzpuntila (talk) 17:45, 28 November 2021 (UTC)

"Finasteride" is repeated many times in the Pharmacokinetics section.

Try reading this out loud, it doesn't really flow. Not sure how to improve it while staying clear though..

At steady-state with 1 mg/day finasteride, mean peak concentrations of finasteride were 9.2 ng/mL (25 nmol/L). Conversely, following a single 5 mg dose of finasteride, mean peak levels of finasteride were 37 ng/mL (99 nmol/L),

Ckiedits (talk) 15:55, 20 March 2022 (UTC)

Extended-confirmed-protected edit request on 21 March 2022

In the Adverse Effects section the comment on contraindication in pregnancy should be improved. The current text is:

Finasteride is contraindicated in pregnancy.[36][37] The Food and Drug Administration advises that donation of blood or plasma be deferred for at least one month after taking the last dose of finasteride.[38]

I suggest, based on Refs 36 and 37, that the above be altered to:

Finasteride is contraindicated for women who are pregnant or become pregnant while exposed to it, as it may cause abnormalities in a male fetus.[36,37] Exposure through skin contact to broken or crushed tablets is identified by as a risk vector. The Food and Drug Administration advises that donation of blood or plasma be deferred for at least one month after taking the last dose of finasteride.[38]

The motivation for this edit is to clarify the information on a serious risk and when it applies. Silverfoil92 (talk) 04:50, 21 March 2022 (UTC)

Removing a floating 'by' from the suggested text.

Finasteride is contraindicated for women who are pregnant or become pregnant while exposed to it, as it may cause abnormalities in a male fetus.[36,37] Exposure through skin contact to broken or crushed tablets is identified as a risk vector. The Food and Drug Administration advises that donation of blood or plasma be deferred for at least one month after taking the last dose of finasteride.[38] Silverfoil92 (talk) 04:52, 21 March 2022 (UTC)

 Not done for now: please establish a consensus for this alteration before using the {{edit extended-protected}} template. Dr.Pinsky (talk) 18:24, 26 March 2022 (UTC)