We have a lot of data about trans women taking finasteride as part of HRT and depression, and the clear correlation runs in the exact opposite direction from what this article is talking about.
> Relative to testosterone, DHT is considerably more potent as an agonist of the androgen receptor (AR).
>> Relative to testosterone, DHT is considerably more potent as an agonist of the androgen receptor (AR).
Judging from this and your other comments in the thread, I'm assuming you're not an endocrinologist.
You're pulling quotes from tertiary sources that at first glance seem to support the argument you're making, but you're missing the broader context, which is that pharmacokinetics and our endocrine systems are way more complicated than you're giving them credit for. It's not as simple as "drug A makes X go down, and X does Y, so A decreases Y".
It would make a lot of people's jobs much easier if that were the case, but the clinical reality is actually much more complicated.
"Drug A makes X go down, and X does Y, so A decreases Y" is a good description of the operation of finasteride and dutasteride (if we disregard the unexplained differences between the effects of the two drugs (we'd naïvely expect one to be strictly "better" than the other, but this is not the case)) on everything except the brain. Everything else responds as you'd expect a priori from modelling hysteresis with pencil and paper. But there's a lot we don't understand about the brain.
a sudden hormonal change can absolutely cause changes to mood and libido, but with finasteride these seem to be rare and generally mild. i would expect them to lessen or even disappear after some time of continued treatment. i wonder how often finasteride is discontinued before the body even has a chance to adjust to the new hormone levels. the claims that the side effects persist after discontinuation are particularly dubious, and they remind me of castration anxiety.
Sure but that's besides the point. I was responding to - and refuting - the claom:
> Reports from trans people, way back in the 1940s, show clear links between sex hormones and depression: a priori, one would assume such a relationship would exist here.
There's no reason to believe that the effects of hormones on depression in trans people are predictive of hormones taken by cis people in completely different doses for different reasons, but it's especially fallacious to assume that it's not only predictive, but predictive of the the exact opposite effect.
This is a really weird argument because it gets so many basic facts wrong. The most fundamental of which is the idea that taking finasteride means lower testosterone levels - it doesn't!
And I'm not even going into the issues with all the other confounding variables at play here, such as the motivations and dosing schedules for HRT being substantially different from other uses of finasteride.
I really don't know why you're bringing up data about HRT for transgender people that's nearly a century old in an article that's not about HRT, when we have plenty of data that's not only far more recent but far more germane to the topic at hand.
I'm bringing up trans HRT in the 1930s (got the decade wrong, sorry!) because the Nobel Prize for the synthesis of testosterone was awarded in 1939. That discovery was made at the start of our understanding of what happens when you muck around with sex steroids: "what effect does this have on mental health?" has always been a question that people have considered, and I was frankly shocked by the article's claim that it hadn't been properly considered in the US.
Of course, others have pointed out that this article is more of a hit piece than a scientific work, so it appears my surprise was justified.