Switching from oral to topical finasteride due to mood issues - 4 months post transplant

General
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Anyone else experienced mental side effects from oral finasteride and switched to topical-only? Here’s my situation

Hey everyone,

I’m currently 4 months post-hair transplant (3,480 grafts), and I’ve seen really good regrowth already so far. I’ve also been treating the crown medically — and it’s showing solid progress — thanks to a combo of minoxidil + finasteride ( DIY solution). I was recommended by the clinic to start finasteride ,EOD except weekends,with 1.25mg pills ( proscar cut in 4).

My regimen:

1.25 mg oral finasteride EOD with weekends included.

Topical minoxidil + 0.05% finasteride topical , 1 mL daily in the morning mostly in a small area in the crown that is not got grafts.

Ketoconazole shampoo twice weekly

Supplements: mushrooms, adaptogens, good nutrition ,mainly carnivore and supplements of whole foods. exercise regularly, lifting weights.

What happened:

Even though I didn’t notice major sexual side effects, I started experiencing unusual brain fog, low mood, emotional flatness, and even panic attacks, especially under stress at work. I’ve worked in high-pressure kitchens for years — but this time, I cracked. I quit my job recently, and it hit me that the emotional intensity felt disproportionate, even though the job was toxic ,I managed way better in different countries , higher pressure environments (Michelin restaurants) and I started thinking that I was burnt out of the kitchen.

After looking into it, I realized oral finasteride may have been the trigger — due to its impact on neurosteroids like allopregnanolone (which modulate GABA, anxiety, mood).

So here’s what I’m doing now:

Stopping oral finasteride completely

Continuing daily topical finasteride (0.05%) + minoxidil

Monitoring mental clarity, mood, and hair progress over the next month

Has anyone here made this switch to topical-only and noticed mental improvement? Did it affect your regrowth or maintenance? How long did it take for brain fog and emotional balance to come back?

Would love to hear others’ experiences — especially if you were sensitive like me but still wanted to stay on treatment.

Thanks in advance.

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Switching to topical fin is a good move if you’re having mental side effects because it generally has fewer of these due to less systemic absorption. Monitor how your mood changes and keep an eye on your hair progress. The topical fin should still help maintain your hair.