Finasteride: A 5 Alpha-Reductase Inhibitor

Finasteride not only inactivates the 5a reductase enzyme but also affects the 5b reductase enzyme in a dose-dependent manner, which can impact sexual behavior and brain activity. The user experienced significant hair regrowth and side effects on 1mg of finasteride, which diminished after reducing the dose to 0.5mg, leading to no side effects and further hair improvement.

The conversation discusses the need for a localized 5-alpha reductase inhibitor that only affects the scalp without systemic side effects, similar to pyrilutamide's approach. Current treatments like topical liposomal finasteride and dutasteride are mentioned, but concerns about their systemic effects and lack of research are highlighted.

FCE 28260 (PNU 156765), an under-explored 5α-reductase inhibitor, showcases promising results in research by Giudici et al., outperforming well-known treatments like Finasteride in reducing the conversion of testosterone to DHT. Its superior efficacy, demonstrated through lower IC50 values in both natural and human recombinant enzyme studies, suggests it could offer more effective management of DHT-related conditions. Additionally, its lower molecular weight hints at better potential for topical application, potentially offering advantages in treating conditions such as androgenic alopecia. Despite its potential, it has not advanced in development, possibly due to financial limitations, leaving its therapeutic prospects and side effect profile largely unexplored.

The conversation concludes that finasteride, a 5α-Reductase inhibitor used for hair loss, does not impair cognition either short-term or long-term. It suggests "brain fog" is not caused by the medication.