The truth about dutasteride’s side effects

Summary

This video compares finasteride and dutasteride, two drugs used to treat hair loss and prostate issues. It highlights that while dutasteride is more potent, both drugs have similar side effect profiles, with low risk for sexual side effects. Despite the higher potency of dutasteride, the risk of side effects is about the same as finasteride. The video also discusses practical aspects such as ease of use and long-term data. Ultimately, both drugs are effective in preventing hair loss, and the choice between them comes down to personal preferences and how well each drug is tolerated.

Takeaways

• 😀 **Dutasteride is more effective than finasteride** in promoting hair growth, as it is a stronger inhibitor of the 5-alpha-reductase enzyme responsible for converting testosterone into DHT.
• 😀 **Both drugs have similar side effect profiles** despite dutasteride being more potent. Common side effects include sexual dysfunction, such as erectile dysfunction, reduced libido, and ejaculation issues.
• 😀 **Meta-analyses show a trend towards fewer side effects with dutasteride**, though these differences were not statistically significant across studies.
• 😀 **No significant difference in the risk of depression or suicidal thoughts** between finasteride and dutasteride, despite concerns about their impact on neurosteroids.
• 😀 **Dutasteride may not cross the blood-brain barrier** as easily as finasteride, which could explain fewer cognitive side effects, though this requires more research.
• 😀 **Both finasteride and dutasteride are low-risk drugs** for severe side effects, and any side effects tend to be temporary, disappearing within a few days or weeks.
• 😀 **Finasteride has a longer track record of use**, with more long-term follow-up data supporting its efficacy even after 10 years of use.
• 😀 **Finasteride offers dose flexibility**, with tablets that can be cut into smaller doses (as low as 0.1 mg/day), making it easier to adjust treatment if side effects occur.
• 😀 **Dutasteride comes in soft gel capsules**, which contain gelatin (an animal byproduct), making it unsuitable for vegans, unlike finasteride which contains minimal lactose.
• 😀 **Switching from finasteride to dutasteride** is an option for those not responding well to finasteride, with no significant increase in side effects based on available data.
• 😀 **Shedding is a normal part of the treatment process**, and it doesn’t mean the drug isn’t working—sticking to the treatment during shedding periods is key for continued progress.

Q & A

What is the primary difference between finasteride and dutasteride?

The primary difference is that dutasteride is more potent than finasteride. It inhibits both type 1 and type 2 5-alpha reductase enzymes, while finasteride only inhibits type 2. This results in dutasteride lowering DHT (dihydrotestosterone) levels more significantly than finasteride.

Do finasteride and dutasteride have similar side effects?

Yes, studies show that the side effect profiles of both drugs are similar. Common side effects, such as altered libido, erectile dysfunction, and ejaculation disorders, do not differ significantly between the two drugs.

Which drug is more effective in promoting hair growth, finasteride or dutasteride?

Dutasteride is more effective than finasteride in promoting hair growth. This is due to its stronger ability to lower DHT levels, which is the hormone responsible for hair loss.

Are the risks of side effects higher with dutasteride compared to finasteride?

No, studies suggest that the risks of side effects are similar between the two drugs. While dutasteride is more potent, it does not lead to a higher incidence of side effects, and in some cases, the risk may even be lower.

Why might dutasteride have fewer side effects despite being more potent?

It is possible that dutasteride does not cross the blood-brain barrier as effectively as finasteride, which could explain the lower occurrence of neurological side effects. However, this remains an area of uncertainty, as the research on how well it crosses the blood-brain barrier is still inconclusive.

Is there any evidence linking finasteride or dutasteride to depression or cognitive issues?

Most studies have not found a significant link between either finasteride or dutasteride and depression or cognitive side effects. A French study even found no increased risk of suicide or self-harm with either drug, despite the potential concerns regarding their effects on neurosteroids.

Can both finasteride and dutasteride be used long-term for hair loss?

Yes, both drugs are safe and effective for long-term use. In fact, finasteride has more extensive long-term data, showing that it remains effective even after 10 years of usage.

What are the advantages of finasteride over dutasteride in terms of dosage adjustments?

Finasteride is easier to adjust in dosage because it comes in tablet form, which can be split into smaller doses. Research has shown that even doses as low as 0.1 milligrams per day can be effective, whereas dutasteride cannot be easily titrated due to its soft gel capsule form.

What should someone do if finasteride isn’t effective enough for them?

If finasteride isn't providing sufficient results after some time, it may be worth considering a switch to dutasteride. However, both drugs have similar side effects, so the risk of experiencing more side effects with dutasteride is low.

Why might some people prefer to stick with finasteride rather than switching to dutasteride?

Some individuals may prefer to stick with finasteride because it has worked well for them over time, and they have concerns about switching to a new medication. Others may also prefer finasteride because it is available in a form that allows for easier dosage adjustments, and they may have ethical concerns about the soft gel form of dutasteride.