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Male Baldness Drug Linked to Decreased Drinking
Kathleen Louden
Jun 21, 2013
A new study finds that most men with finasteride (Propecia, Merck & Co., Inc.)?related sexual dysfunction lasting months to years after discontinuing use of the hair loss medication reported that they had reduced or stopped drinking alcohol.
Of 63 men in a case series who consumed at least 1 alcoholic beverage before starting oral finasteride treatment of male-pattern hair loss, 41 (65%) said they decreased their alcohol consumption after no longer taking finasteride, said study author and endocrinologist Michael Irwig, MD.
"These men with persistent sexual side effects said alcohol did not have positive effects. They had a longer hangover or less tolerance to alcohol [after finasteride treatment]," Dr. Irwig, assistant professor of medicine at George Washington University in Washington, DC, told Medscape Medical News. "So they decreased their drinking or stopped entirely."
The study results were published online June 13 in the journal Alcoholism: Clinical and Experimental Research ahead of November publication.
These findings suggest that finasteride has the ability to modulate alcohol intake in humans, which is consistent with past research in male mice, Dr. Irwig said.
No Longer Could Tolerate Alcohol
Finasteride, also available for treatment of benign prostatic hyperplasia under the brand name Proscar, is a 5α-reductase inhibitor with antiandrogenic activity. These medications interfere with the body's production of some neuroactive steroids that are involved in a range of processes, including depression, anxiety, and possibly alcohol use, according to Dr. Irwig.
The investigator studied 83 men, ranging in age from 21 to 46 years, who sought treatment of sexual dysfunction, such as low libido and erectile dysfunction, which had continued despite stopping use of finasteride 3 months to more than 6 years earlier. Standardized interviews asked about alcohol use before and after finasteride treatment (mean treatment duration, 26 months).
Of the 63 men who reported drinking before finasteride treatment, the mean (? standard error) number of alcoholic beverages they recalled drinking weekly decreased from 5.2 ? 0.7 to 2.0 ? 0.3 drinks after they stopped taking finasteride (P < .0001), the article notes. Twenty-three men reported reduced alcohol consumption, 18 said they gave up drinking entirely, 20 men said they had no change in alcohol use, and 2 reported increased drinking.
Some participants volunteered information that they reduced or stopped alcohol consumption because they "no longer could tolerate alcohol the same as before" finasteride treatment, Dr. Irwig reported. He cautioned that the study could have recall bias, because some men had stopped taking finasteride as long as 5 or 6 years from the time of the survey.
Although the findings may not apply to alcoholic individuals who are without hair loss, they warrant further research of finasteride, he said, noting, "The central nervous system side effects of this medication have been understudied."
Premature to Prescribe Finasteride
Asked by Medscape Medical News to comment on this study, Jonathan Covault, MD, PhD, a professor of psychiatry at the University of Connecticut School of Medicine, Farmington, said the study is "provocative, but it's premature to have any day-to-day clinical impact."
An alcohol researcher who was not involved in the new study, Dr. Covault said, "This preliminary report adds to the small [amount of] literature in humans studying the effects of 5α-reductase inhibitors on alcohol use. More study is needed in humans before these drugs can be given to patients for alcohol dependence."
Dr. Irwig also cautioned against physicians rushing to prescribe finasteride for the reduction of alcohol use.
As Dr. Irwig commented in his article, the study suffered from not having a control sample, Dr. Covault said. He added that the study population represents "a small minority of the millions of patients who are treated with finasteride for male-pattern baldness."
Although Dr. Covault said that the percentage of patients who experience sexual side effects from finasteride is unknown, Dr. Irwig estimated it to be less than 5%.
Dr. Irwig and Dr. Covault have disclosed no relevant financial relationships.
Alcohol Clin Exp Res. Published online June 13, 2013. Abstract
Medscape Medical News ? 2013 WebMD, LLC
Send comments and news tips to [email protected].
Cite this article: Male Baldness Drug Linked to Decreased Drinking. Medscape. Jun 21, 2013.
Kathleen Louden
Jun 21, 2013
A new study finds that most men with finasteride (Propecia, Merck & Co., Inc.)?related sexual dysfunction lasting months to years after discontinuing use of the hair loss medication reported that they had reduced or stopped drinking alcohol.
Of 63 men in a case series who consumed at least 1 alcoholic beverage before starting oral finasteride treatment of male-pattern hair loss, 41 (65%) said they decreased their alcohol consumption after no longer taking finasteride, said study author and endocrinologist Michael Irwig, MD.
"These men with persistent sexual side effects said alcohol did not have positive effects. They had a longer hangover or less tolerance to alcohol [after finasteride treatment]," Dr. Irwig, assistant professor of medicine at George Washington University in Washington, DC, told Medscape Medical News. "So they decreased their drinking or stopped entirely."
The study results were published online June 13 in the journal Alcoholism: Clinical and Experimental Research ahead of November publication.
These findings suggest that finasteride has the ability to modulate alcohol intake in humans, which is consistent with past research in male mice, Dr. Irwig said.
No Longer Could Tolerate Alcohol
Finasteride, also available for treatment of benign prostatic hyperplasia under the brand name Proscar, is a 5α-reductase inhibitor with antiandrogenic activity. These medications interfere with the body's production of some neuroactive steroids that are involved in a range of processes, including depression, anxiety, and possibly alcohol use, according to Dr. Irwig.
The investigator studied 83 men, ranging in age from 21 to 46 years, who sought treatment of sexual dysfunction, such as low libido and erectile dysfunction, which had continued despite stopping use of finasteride 3 months to more than 6 years earlier. Standardized interviews asked about alcohol use before and after finasteride treatment (mean treatment duration, 26 months).
Of the 63 men who reported drinking before finasteride treatment, the mean (? standard error) number of alcoholic beverages they recalled drinking weekly decreased from 5.2 ? 0.7 to 2.0 ? 0.3 drinks after they stopped taking finasteride (P < .0001), the article notes. Twenty-three men reported reduced alcohol consumption, 18 said they gave up drinking entirely, 20 men said they had no change in alcohol use, and 2 reported increased drinking.
Some participants volunteered information that they reduced or stopped alcohol consumption because they "no longer could tolerate alcohol the same as before" finasteride treatment, Dr. Irwig reported. He cautioned that the study could have recall bias, because some men had stopped taking finasteride as long as 5 or 6 years from the time of the survey.
Although the findings may not apply to alcoholic individuals who are without hair loss, they warrant further research of finasteride, he said, noting, "The central nervous system side effects of this medication have been understudied."
Premature to Prescribe Finasteride
Asked by Medscape Medical News to comment on this study, Jonathan Covault, MD, PhD, a professor of psychiatry at the University of Connecticut School of Medicine, Farmington, said the study is "provocative, but it's premature to have any day-to-day clinical impact."
An alcohol researcher who was not involved in the new study, Dr. Covault said, "This preliminary report adds to the small [amount of] literature in humans studying the effects of 5α-reductase inhibitors on alcohol use. More study is needed in humans before these drugs can be given to patients for alcohol dependence."
Dr. Irwig also cautioned against physicians rushing to prescribe finasteride for the reduction of alcohol use.
As Dr. Irwig commented in his article, the study suffered from not having a control sample, Dr. Covault said. He added that the study population represents "a small minority of the millions of patients who are treated with finasteride for male-pattern baldness."
Although Dr. Covault said that the percentage of patients who experience sexual side effects from finasteride is unknown, Dr. Irwig estimated it to be less than 5%.
Dr. Irwig and Dr. Covault have disclosed no relevant financial relationships.
Alcohol Clin Exp Res. Published online June 13, 2013. Abstract
Medscape Medical News ? 2013 WebMD, LLC
Send comments and news tips to [email protected].
Cite this article: Male Baldness Drug Linked to Decreased Drinking. Medscape. Jun 21, 2013.
