Surprise! Treating ADHD using Finasteride, why isn’t this better studied?

Anecdotal

I asked my Doctor about taking Finasteride and was surprised when I was immediately prescribed a 5mg dose rather than 1mg. I decided to try it at that dosage anyway to better note any side effects.

I was expecting to feel tired and weak, lose erections and libido, etc. but instead I noted that I was anxious – wired, had more spontaneous erections, and my muscles were tense. I disregarded it and stuck to the 5mg dose each day for a week. Finally it hit me – Finasteride felt just like a “high dose” of Adderall to me. Off hand perhaps 5mg of Finasteride felt like 20mg of Adderall – higher than my comfort zone due to side effects of anxiety and muscle tensing, etc.

I was convinced the effect must be from Finasteride, so I dug deeper and found this article:

Methods
Open‐field behaviors were evaluated by exploratory and motor behaviors. Dopamine and its metabolites were assayed by liquid chromatography‐mass spectrometry. Tyrosine hydroxylase mRNA and protein expressions were determined by real‐time qRT‐PCR and western blot, respectively.

Results
It was found that in adolescent male rats, administration of finasteride at doses of 25 and 50 mg/kg for 14 days dose dependently inhibited open‐field behaviors, reduced contents of dopamine and its metabolites in frontal cortex, hippocampus, caudate putamen, nucleus accumbens, and down‐regulated tyrosine hydroxylase mRNA and protein expressions in substantia nigra and ventral tegmental area. However, there was no significant change of these parameters in early developmental rats after finasteride treatment.

Conclusion
These results suggest that finasteride inhibits dopaminergic system and open‐field behaviors in adolescent male rats by inhibiting the conversion of testosterone to dihydrotestosterone, and imply finasteride as a potential therapeutic option for neuropsychiatric disorders associated with hyperactivities of dopaminergic system and androgen.

https://onlinelibrary.wiley.com/doi/full/10.1111/cns.12781

So what? Finasteride may be a treatment for ADHD, why is that so surprising? This primarily blew my mind because Finasteride is widely used in the transgender community as an anti-androgen / DHT blocker, yet I’ve never encountered anyone who mentioned feeling like Finasteride acted like Adderall (amphetamine salts). ADHD also has a large overlap in the trans community, so what the heck is going on here?

For now I’m going to chalk up this gray area to the fact that I am notably introspective and neurologically highly sensitive to chemical changes in my brain. My psychiatrist has noted many times that I am very high sensitivity when it comes to any chemical changes.

What really rubs me the wrong way about the lack of study is that there may actually be interactions between Finasteride and Ritalin like there is between Ritalin and Adderall; yet, because Finasteride isn’t well studied for ADHD these contraindications may be undocumented. For now if you are on another ADHD treatment I would suggest that you take note of how Finasteride is affecting you and potentially drop the other ADHD treatment if Finasteride is doing the trick for you.

Personally I function best on Ritalin; and Finasteride/Adderall both make me anxious and physically tired, yet wide awake mentally. It’s an unproductive feeling in my case. I am halving my Finasteride dose to 2.5mg daily and will switch over to Dutasteride for the next refill cycle.

Note that off hand I could not find information about Dutasteride and ADHD and probably am lucky to have found any information about Finasteride and ADHD; so I can’t say whether there is any interaction or therapeutic value for ADHD with Dutasteride, but I will be on the lookout and document accordingly in case it helps anyone else.