Merck's Drug Propecia Linked To Sexual Dysfunction 235
zaxios writes "Merck — the pharmaceutical giant previously featured on Slashdot for drawing up a 'hit list' of doctors that criticized its drug Vioxx, and creating a fake medical journal to endorse its products — is embroiled in a new scandal. USA Today is reporting on two new studies that show Propecia, Merck's $250 million prescription medication for baldness, can make men irreversibly impotent. Lawsuits have been filed in the United States and Canada from men claiming to have permanently lost their sexual function after taking the drug. All this is reminiscent of Merck's difficulties with Vioxx, a once $2.5-billion-a-year drug, which was withdrawn from the market in 2004 after a study showed it doubled the risk of heart attack and stroke in users."
Re:Nah (Score:4, Informative)
It's not so much about genetic strength as about power. Here is the explanation in evolutionary psychology terms.
Male pattern baldness is an evolved feature that relies on hormonal pathways to trigger. Evolved, meaning it gives an advantage in terms of more success with women, more kids, kids who live longer, and do better.
Why would going prematurely bald give a man success? The reason is, IMO, about power. Men instinctively trust older men (who know more, have survived, are worth listening to). Premature baldness makes a man look older than he really is. That's a sneaky way to grab power. It demands intelligence, because unless you're smarter than your peers you can't fool them into following you. So there's an inherent association between baldness and smartness.
I once studied the 100 most powerful people in the UK (Economist report). 4 were women, 96 were men. Of the 96, a significant number were bald, but there was no correlation between baldness and age. I.e., as many younger men with power were as bald as older men.
Now, as to why men worry about losing their hair? I'd guess, insecurity. Going bald is a gambit, a risk. Obviously you lose attractiveness to women who are looking for a long term partner. You're unlikely to find a woman who wants to settle and raise a family. But if you can pull it off, and get men to follow you, you get power, and a lot of women find that irresistible.
So the anti-baldness industry caters to insecure men, just as the beauty industry caters to insecure women. Another reason for being proudly bald, it shows not only that you're a born leader of men, smarter than average, and the latest in a long line of winners, but also that you're confident.
Re:Frankly this lawsuit shit.. (Score:5, Informative)
Whether a drug is worth the risk for the benefits should be up to the PATIENT, not some damned ambulance chaser!
Right, and in this case the patients weren't warned of the risk of irreversible impotence, only reversible impotence that was supposed to go away after they stopped taking the drug. They weren't in any position to weigh up the real risks and benefits, and have every right to sue the pharmaceutical company for that.
Re:Uh, of course it causes impotence, dumbasses... (Score:5, Informative)
...Propecia is an anti-androgen! Duh.
This is the correct answer. Anyone that doesn't understand this shit should be suing their doctor for not telling them, not the drug company.
Antiandrogens are only supposed to have that effect temporarily, while you're taking them. The significance of these new studies is that they show Propecia is causing permanent impotence - it persists even after you stop the drug. That is not a known behaviour of antiandrogens, and was not disclosed to patients considering Propecia.
Re:This drug really screws up female fertility (Score:4, Informative)
20 years ago, I knew a lady who worked at Merck, about the time Propecia was "discovered". In reality, it was developed as a drug for another purpose (something to do with the prostate) and the hair growth was a side effect. She, and no other females, were allowed in the production area, as exposure caused irreversible infertility in females, and it was really bad for pregnant women.
Your story is absolutely bogus. Propecia cannot cause infertility in women, as it causes a breakdown in the development of Dihydrogen-testosterone from Testosterone by blocking the 5-alpha-reductase enzyme. (It is a 5a-reductase inhibitor.) Women do not need testosterone or testosterone-analogs for fertility, thus Propecia has no mechanism whereby it could cause infertility in women. (In men? Yeah, it by definition will cause testosterone-analog "deficiency", which can include sexual dysfunction.)
Rather, the real reason why pregnancy is so bad is that if you are being exposed to a 5-alpha-reductase inhibitor is that if a child developing in the womb has an XY genotype, then they will develop with 5-alpha-reductase deficiency [wikipedia.org] and if the concentrations are high enough, they will develop female primary sexual characteristics despite having testicles and Wolfian ducts.
Re:Uh, of course it causes impotence, dumbasses... (Score:5, Informative)
Some anti-androgen drugs are not permanent in their disruption of the androgen system... Cyproterone, for example, is normally used to treat prostate cancer (and also used for hirsutism and baldness in females, and for MtF transsexuals (though AFAIK, it's not approved for that use in the US)), and works by binding with testosterone receptors, blocking testosterone uptake, which in turn causes the body to freak out and stop producing the lutenizing hormone, which in turn stops the signal to produce testosterone. Once you stop taking Cyproterone, however, the body starts producing the testosterone again, and normal sexual function should return for males.
Such a drug *could* be used to temporarily stay baldness, but again, as soon as you stopped taking the drug, the mechanism that's causing the baldness would start again.
Though there's another major reason that males shouldn't be taking anti-androgen drugs... you don't have enough estrogen in your systems to stay off osteoperosis without the testosterone in your systems. Females do have the estrogens, and transsexuals are taking the estrogens, but males should *not* be taking an anti-androgen for a prolonged period of time because the lack of testosterone will cause your bone density to fall... IMO, that's a far more serious life problem than losing your hair, but I guess some folks are vain. :(
obligatory disclaimer: I'm not a doctor, but I do know several people who are taking the drug in question, both to treat hirsutism and for transsexualism.
Re:Uh, of course it causes impotence, dumbasses... (Score:4, Informative)
It's been known for decades that continual ingestion of anti-androgens (for a period of over 6 months) can cause permanent loss of potency.
Simply wrong. They provide a loss of potency while on the medication - which, in the case of prostate cancer, is usually years. And yes, the loss of potency worsens after several months. But it does not persist after treatment. Here is a quote from Merck's page for Propecia [propecia.com]: "A small number of men had sexual side effects, with each occurring in less than 2% of men. These include less desire for sex, difficulty in achieving an erection, and a decrease in the amount of semen. These side effects went away in men who stopped taking PROPECIA because of them." That information has turned out to be wrong. Are you seriously telling me they shouldn't be liable for giving prospective patients wrong information about side effects? If so, why not?
Re:Frankly this lawsuit shit.. (Score:4, Informative)
No, they don't have every right to sue the pharma company. Unless they can prove also that the pharmaceutical company knew about the problem and intentionally hid the information.
Well, not quite. It varies from jurisdiction to jurisdiction, but at least in my country I believe the standard is a negligent, not intentional, failure to disclose the risk.* So, it's only necessary to show that the pharmaceutical company should have known, not that they did. I would be surprised if that is not the case here. Merck has reportedly been tipped off numerous times by patients and doctors over the past 10 years and has not acted. Moreover, the drug has shipped in Europe with a persistent sexual side effects warning since 2008 due to pressure from regulators there. How ignorant could Merck be then? Not to mention Merck's history: they essentially covered up the side effects of Vioxx only a few years ago.
I should add that I fully agree that a drug company that quite innocently puts a drug on the market having taken all prudent measures to ensure all relevant risks are disclosed should not be held responsible for issues that weren't foreseeable at the time. But this situation is unlikely to be one of those times.
If you read the description label and it lists impotence as a side effect, temporary or otherwise, you don't take that drug, unless you are happy to be permanently impotent.
Sorry, but how on earth does that make any sense? Temporary impotence which goes away as soon as you stop taking the drug is not even remotely similar to losing sexual function for the rest of your life. I am inclined to think the men involved in this debacle agree.
*There is also a statutory cause of action under consumer protection legislation that sets an even lower standard for the plaintiff, but I can't recall the elements off the top of my head.