Talk:Post-finasteride syndrome

Edit request
I just noticed that the redirect here was set to Finasteride. It should have been set to Finasteride, because a) this proposed syndrome is discussed there in the finasteride article, and b) as the AfD discussion made very clear, this syndrome has not been recognized in the medical mainstream, although the advocacy group pushing for it has said that it was. (see this post at HealthNewsReview.org). The redirect should not go to Finasteride, which makes it appear that this is an adverse effect of the drug.

I also just now noticed, that last month the alternatively-titled Post-finasteride syndrome was created, and have tagged that for speedy per G4. Jytdog (talk) 16:26, 6 May 2018 (UTC)
 * Yes check.svg Done Indeed, it seems reasonable. I have edit protected the alternate title too. Thanks! -- Luk  talk 12:17, 10 May 2018 (UTC)

Edit request
It should be noted that study 047 of Merck's Propecia clinical trials had at least one patient suffer from unresolved impotence (page 18) after long term cessation of the drug. This is important because many users of the drug are convinced by Merck's fraudulent label claiming all men had side effects "go away." BugBrainsWay (talk) 18:37, 29 March 2021 (UTC)

Draft Pending
A draft has been submitted for review at Draft:Post-Finasteride Syndrome. Discussion should focus on whether the syndrome has been recognized in the medical mainstream in the past eight years. Robert McClenon (talk) 15:55, 25 March 2021 (UTC)

Reviewer Note
See Articles for deletion/Post-Finasteride Syndrome. This title was deleted and redirected to Finasteride, and the title is now fully protected, due to sockpuppetry. A request has been made to downgrade the protection to ECP. Discussion should focus on whether the syndrome has been recognized in the past eight years. Robert McClenon (talk) 15:53, 25 March 2021 (UTC)

Reviewer Comment
My conclusion is that this draft satisfactorily addresses the controversy about the syndrome, and should be accepted.

The history associated with the redirect is not substantial, and the redirect will be moved and deleted so that the draft can be accepted. (The deleted article is deleted. The redirect was added after the deletion, not as a cutdown.)  Robert McClenon (talk) 23:12, 27 March 2021 (UTC)
 * Hi Robert, finasteride should be lower case, so the title would be Post-finasteride syndrome. SarahSV (talk) 23:28, 27 March 2021 (UTC)
 * User:SlimVirgin - Round and round the robin flies. Robert McClenon (talk) 00:03, 28 March 2021 (UTC)
 * Examples of all lower-case: BMJ, PFS Foundation, Wall Street Journal. SarahSV (talk) 00:08, 28 March 2021 (UTC)
 * , could you respond, please? I don't know what "Round and round the robin flies" means. SarahSV (talk) 17:26, 28 March 2021 (UTC)
 * User:SlimVirgin - That meant that I had done a round-robin move. However, I moved it to Post-finasteride Syndrome.  I am now trying to move it to post-finasteride syndrom, but I find that that redirect is another that has been fully protected.  In order to make the primary title of the article be Post-finasteride syndrome, an administrator will need either to unprotect Pfs and to allow me to do another round-robin move, or to perform a round-robin move themselves.  Can you at least unprotect Post-finasteride syndrome so that the article can be moved there?  Robert McClenon (talk) 18:00, 28 March 2021 (UTC)
 * , done. SarahSV (talk) 18:04, 28 March 2021 (UTC)
 * User:SlimVirgin - This is now Post-finasteride syndrome. I will later today create redirects for all of the capitalization variants.  Robert McClenon (talk) 18:16, 28 March 2021 (UTC)
 * Thanks for doing that. SarahSV (talk) 18:42, 28 March 2021 (UTC)

Why was this article recreated?
The old page was deleted and PFS was not recognized as a real condition by the medical community in the meantime Scisne (talk) 17:14, 28 March 2021 (UTC)


 * You can join the discussion on the matter at Talk:WikiProject Medicine. NikosGouliaros (talk) 18:03, 28 March 2021 (UTC)

Merger proposal
I propose to merge this previously-deleted article, Post-finasteride syndrome, into Finasteride per WP:NOPAGE and WP:NOV. I think that the content in the current Post-finasteride syndrome article can better be explained in the context of Finasteride generally, and the Finasteride article is of a reasonable size that the merging will not cause any problems of excessive size. Alexbrn (talk) 07:12, 29 March 2021 (UTC)

Survey

 * Support as proposer. Alexbrn (talk) 07:12, 29 March 2021 (UTC)
 * Oppose as author. Sugarhouse90 (talk) 10:43, 29 March 2021 (UTC)
 * Are you going to give any rationale? Do you believe WP:NOPAGE does not apply for example? Alexbrn (talk) 10:51, 29 March 2021 (UTC)
 * I have addressed this in reply to the initial comments you made on Talk:WikiProject Medicine
 * I don't think you have. Anyway, if this discussion is closed by a neutral observer, they will evaluate the weight of arguments here. Remember such discussions on Wikipedia are WP:NOTAVOTE. Alexbrn (talk) 14:26, 29 March 2021 (UTC)


 * Support. Once cleared of information from multiple sources of questionable reliability, the topic appears for what it is: an unproven, litigation-related syndrome, which as of today is bound to remain a stub for lack of coverage in reliable sources, and which can be perfectly covered with a short paragraph in finasteride. NikosGouliaros (talk) 13:48, 29 March 2021 (UTC)
 * Support addressing the concerns about side effects in Finasteride; this page/title should redirect to that section. Information about the lawsuit should be in the ==Society and culture== section (which probably also needs information about why men think balding is a problem).  I think it will be easier to maintain WP:DUE weight if all of the contents are on the same page.  WhatamIdoing (talk) 17:37, 29 March 2021 (UTC)
 * Support a curated merge of important information to a dedicated subheading on finasteride (suggest: Persistence of side effects or similar). I doubt this is notable enough to stand on its own - while the term is used sometimes, it is not clearly defined and is used as a descriptor by sources more than a name of one syndrome with definition. -bɜ:ʳkənhɪmez (User/say hi!) 17:02, 29 March 2021 (UTC)
 * I thought I'd commented on this! re-adding and signing as I think it was inadvertently removed. -bɜ:ʳkənhɪmez (User/say hi!) 23:24, 29 March 2021 (UTC)
 * Support Per proposer and WAID. -Roxy the sycamore . wooF 11:29, 30 March 2021 (UTC)
 * Support Scisne (talk) 15:01, 30 March 2021 (UTC)
 * Oppose PFS research intersects with other medical sciences like pharmacology, epigenetics, and prostate cancer research. Hundreds of papers, many with cutting-edge research, have been published on PFS. PFS is similar to other iatrogenic diseases like Post SSRI Sexual Dysfunction (PSSD).  Pharmacovigilant agencies like New Zealand's MedSafe recognize PFS as a medical condition.  Wikipedia should too. AntiSemanticCanard (talk) 08:07, 1 April 2021 (UTC) — AntiSemanticCanard (talk&#32;• contribs) has made few or no other edits outside this topic.
 * Support. Doesn't warrant an independent article. I suppose the alternative would be to delete this entirely as a POV fork. - MrOllie (talk) 13:20, 1 April 2021 (UTC)

ready to move

 * Okay this seems pretty clear-cut. If nothing significant changes in the next couple of days's I'll perform the merge (unless somebody wants to do it instead!) Alexbrn (talk) 14:39, 5 April 2021 (UTC)

Repeated erroneous edits and misleading justifications
Since this was submitted and approved, Alexbrn has been repeatedly and rapidly removing content and citations from this article without detailed objections being raised. This followed an initial immediate deletion and redirect of the article without discussion, after it had just been reviewed and approved. These edits are substantively reducing the quality of the article and unjustifiably removing important research findings. If a peer-reviewed, case-controlled study has reported findings in Post-finasteride syndrome patients and it has then been referenced in further peer-reviewed literature, this is important and relevant to the condition and should not be outright removed, simply saying the sources are "dodgy", "roaring POV" and "dishonest representations". None of these claims are detailed in discussion and appear to be using Wikipedia terms to erase plainly reported findings that appear in multiple reviews. Such terms include WP:POVFORK, and now WP:NOPAGE and WP:NOV. The errors made in these edits demonstrate a lack of familiarity with the subject and source material, and the pace of these edits after attempted removal indicates very little time has been spent assessing the references. An example of these errors is editing in that unsealed manufacturer documents were "plaintiff allegations", which after being corrected, was immediately reinstated. A further example is the removal of review citations on the grounds they did not meet WP:MEDRS guidelines but has not detailed why. Discussion tangental to this in Talk:WikiProject Medicine speculated the journal "Current Sexual Health Reports" wasn't peer-reviewed or on Pub-Med, which is erroneous. The submission guidelines for this journal mention peer review process. Additionally the journal is present in Pub-Med. Controversies were noted by the reviewer as well-addressed at the outset of the article and I would ask that the serious nature of these reported symptoms should demand a more considered engagement with the topic. As this is a controversial topic and seems to attract people with strong POVs based in their own past assessments (see the written tone, including the word syndrome in quote marks at the outset of Talk:WikiProject Medicine and baselessly being called a "litigation-related syndrome" when important findings continue to emerge years after a now-settled lawsuit), I would value an opinion from  on if it is possible to keep the content from constantly being erroneously altered, as it is making the article near-impossible to maintain. Sugarhouse90 (talk) 14:08, 29 March 2021 (UTC)
 * Please see the discussion at WT:MED for some further details on why the initial sourcing here was unacceptable by Wikipedia's standards for biomedical content. You cannot personally take an editorial decision to morph what Reuters reports as allegations, into an assertion of fact. Wikipedia reports neutrally on such matters as an observer, not a litigant with a case to press. Note that "peer review" does not mean an article is a review article (which type of article Wikipedia typically wants for health content): maybe see WP:MEDFAQ and WP:WHYMEDRS for explanatory background information. If you a have a specific suggestion for restoration of some content, please explain why – remember the WP:ONUS to gain consensus is on editors seeking to include disputed content. Alexbrn (talk) 14:17, 29 March 2021 (UTC)
 * The discussion at WT:MED asserted the sourcing was unacceptable because the articles were not peer-reviewed and the journals not on PubMed, which I have addressed immediately above highlighting an error in your justification for removal. Again, the articles are peer-reviewed and the journals are listed on PubMed. Reuters' report included documents from the clinical trials, and emails circulated by Merck employees overseeing the trials, that acknowledged the presence of persistent adverse effects in patients, that were not warned about on the original label. The disputes you mention are repeatedly resulting from faulty justifications for edits that don't seem to have considered the source material or are making assertions about the veracity or representations of sources which are demonstrably untrue. My specific suggestions are that the Than, Traish and Frye literature review citations are reinstated, along with the research findings regarding AR (CAG)n and (GGN)n repeat lengths correlating to self-reported symptoms, and fMRI findings. Also, I suggest you revert the edit to the Reuters citation as it is now erroneous. Sugarhouse90 (talk) 14:51, 29 March 2021 (UTC)
 * Peer review alone is not a sufficient criterion for reliability; please see the links I gave. Reuters is quite careful in what is reported, and I have included a quotation in the reference to avoid doubt. We need to reflect that honestly; it is not our job to say something different based on an personal interpretation of primary court documents. We are not going to include primary research – this generally holds for all medical content on Wikipedia. We already include a "Traish" source. If you mean another, please give its PMID to avoid ambiguity, and to avoid us all wasting time with articles that have not even appeared in PUBMED. Alexbrn (talk) 14:54, 29 March 2021 (UTC)
 * You have editorialised and this must be addressed. The line as it stands regarding Reuters is factually mistaken and at best misleading with "allegations from plaintiffs" edited into it, and a partial quote used to justify this. The start of the line has been chopped off: "Citing internal documents,". The title of the article is "Court let Merck hide secrets about a popular drug’s risks", but to expand further: These documents were unsealed by Reuters and further reported again, this time more plainly: https://www.reuters.com/article/us-merck-propecia-suicide-exclusive-idUSKBN2A32XU . With reference to the aforementioned documents: "the 2009 risk management report also shows that the company was aware of reports that those sexual problems continued for some men after they stopped taking the drug." It is necessary therefore to revert the line to the accurate summation I provided, its placement removed from your newly created "legal" section and put back into "controversies", and this further citation added to avoid any attempts at introducing ambiguity to the matter. It is not even debatable that an at-the-time future lawsuit's "allegations" could form the substantive basis for this internal company report showing evidence of persistent sexual dysfunction at the trial stages, years beforehand. Also, my requests for specifics in vague references to guidelines have continually been ignored. Again, the assertion in WT:MED was that the sources did not meet guidelines because they were not peer-reviewed or listed on PubMed, which you have again used for the basis in your claim above. Now that I have proven they are, the goalposts have shifted and you've vaguely pointed again to the guidelines. It is entirely unclear what criterion these sources do not meet. Unbroken rules are being thrown around until one sticks, while avoiding substantive engagement with the content. You have now ENTIRELY removed peer-reviewed case-controlled findings which are summarised in multiple peer-reviewed literature reviews. This is a dramatic step considering their relevance to the clinical problem. Your approach has been to remove science and add opinion from the outset. The only single journal publication you have actually expanded upon was a hair clinician with an undeclared financial COI making a hypothesis outside his medical area with no basis, while removing secondary literature from well-renowned steroid biologists reporting the findings of case-controlled investigations. Removing core content from the article is also serving to reduce it significantly, supporting a straw poll for deletion, which initially, you remarkably did without discussion after approval. I hope this chain of events stays well recorded here for the future, as it is absolutely disgraceful. Doctors interested in a condition will reference Wikipedia for what has been investigated and found in research, not the thoughts of a Wikipedia editor with cemented and out-of-date viewpoints, trying to drag a controversial but increasingly researched situation into a personal crusade against what he has decided to be pseudoscience. Distorting science does it no justice. Sugarhouse90 (talk) 09:07, 30 March 2021 (UTC)


 * If you say "peer review alone is not sufficient" then why are there claims of PFS being related to Morgellons disease? There is zero scientific evidence, certainly none published in a credible peer review journal, that demonstrates that. It's also compared to "multiple chemical sensitivity."  PFS research has been published in dozens of top-tier academic journals yet most get deleted from being cited in the entry.  Clinical findings on PFS are being eschewed in favor of baseless speculation and bizarre claims of "mass delusions."  You have one standard for one argument, then a completely different standard for another. BugBrainsWay (talk) 18:43, 29 March 2021 (UTC)
 * "Current Sexual Health Reports" is not Medline-indexed, as you can see here (where it is explained why you can find some articles on PMC/Pub-Med) and here. From your other link, I see it may have been a mistake to say it's not peer-reviewed, so I retract. I firmly believe non-Medline-indexed journals cannot be cited for controversial issues.
 * Since there are pending connected cases, I cannot see why it is wrong to call post-finasteride syndrome a litigation-related syndrome. Please note I have also called it an unrefuted syndrome.
 * I regard my engagement with the topic as considered and responsible. NikosGouliaros (talk) 15:19, 29 March 2021 (UTC)

Vandalism
Due to the belligerent approach, and removal of significant findings and reduction in quality, the article has been so gutted and editorialised that is no longer informative and is now being openly vandalised. Sugarhouse90 (talk) 10:46, 30 March 2021 (UTC)
 * Have you got any Diffs to support your attack? Otherwise you are wasting our time making false allegations. -Roxy the sycamore . wooF 11:24, 30 March 2021 (UTC)
 * The word "Mythical" was inserted before "Post-finasteride syndrome" and "nocebo" into the description of the condition. A total misrepresentation of the source material and clear vandalism. Sugarhouse90 (talk) 11:43, 30 March 2021 (UTC)
 * Do you mean the vandalism that was removed by Skindeisel? -Roxy the sycamore . wooF 11:53, 30 March 2021 (UTC)
 * Vandalism happens; vandalism gets fixed (and there are some trolls who watch Wikipedia and make sure to "stir the pot" when a controversy flares up, as it has here). This is just a routine happening at Wikipedia. WP:ADVOCACY and WP:SPAs also happen. Their damage also gets fixed - in time, because it takes more work. That is happening here too. Alexbrn (talk) 12:31, 30 March 2021 (UTC)

More off-wiki stuff
Note the twitter advocacy account "Finasteride Info" has pointed their followers at this discussion, probably explaining the influx of problematic new WP:SPAs (or maybe it's socking?) Alexbrn (talk) 17:24, 31 March 2021 (UTC)
 * Good catch. -Roxy the sycamore . wooF 17:31, 31 March 2021 (UTC)
 * This isn't evidence of any "recruiting". I've been passively following this discussion and have nothing to do with any tweets, I haven't made a single edit to this article.  I have a dynamic IP so it may seem I am multiple people but I am not, you can IP check for socks and you are unlikely to find anything, and referring to a wiki article on the internet as a place to not even monitor but to "follow the edit history" is in no way an attempt or any effort to recruit.  As a passive follower, it seems to be you have been extremely uncooperative and not acting in good faith. 2603:7000:2400:1E91:3071:66FE:3916:7EA (talk) 19:09, 31 March 2021 (UTC)
 * Nobody is suggesting that any one person was recruited here, but the bottom line is that recruiting has occurred - telling people to "follow the edit history" is the definition of recruiting others to the article off-wiki. -bɜ:ʳkənhɪmez (User/say hi!) 19:11, 31 March 2021 (UTC)
 * There is literally ZERO evidence that a single person on here was "recruited" anywhere else and that tweet absolutely did not recruit. It merely tweeted about the article and provided a link offering no suggestion to participate let alone in what capacity.  This page has been sadly ransacked by AlexBRN who appears to have been ransacking the finasteride page for years.  From my perspective, all that I see here, is a relatively new editor attempted to create a new page in good faith and was bullied by Alexbrn into desecrating this page.  This was zero cordiality, little to no constructive feedback, and zero effort put in to collaborate with the author.  The same day the article was accepted, Alex tried to unilaterally delete the page and I believe the approving member/admin? quickly reverted him. It's truly a disgrace, but since this page is clearly not going to remain in place, I think it should just be deleted to put an end to this continued unpleasantness.


 * And absolutely not, telling somebody to follow a page and edit it to advocate for a specific POV constitutes evidence of recruitment. Providing info about the current status of the article and telling people you CAN but not even SHOULD follow an edit history, is absolutely not recruiting.  I ask you to muster just the smallest bit of intellectual honesty and really consider whether you think that was an actual attempt to recruit because there is no evidence that a single editor here was recruited as far as I can see. The Twitter account is obviously meant to be informative as is clear from the twitter handle and its bio section with a very detailed bibliography.  Please, just be slightly reasonable here. 2603:7000:2400:1E91:3071:66FE:3916:7EA (talk) 20:04, 31 March 2021 (UTC)
 * Dishonest shills trying to use Wikipedia as a platform for misinformation and advocacy are not editors in good faith, but a negative drag on the Project. No admin restored this page ever. If you have a complaint about me or any other editor, take it to ANI for scrutiny by the community. Ranting here is just a waste of time. Alexbrn (talk) 04:05, 1 April 2021 (UTC)
 * Calling knowledgeable editors "dishonest shills" proves how dishonest you are. You have been thoroughly taken to task by the so called "meat puppet" and your only retort is to call them "dishonest shills." Not only have you demonstrated you do not understand PFS research, but you have no interest in learning. The research and timeline clearly indicate PFS is a real phenomenon and it should be discussed thoroughly. The original Proscar label of 1992 warned patients of permanent sexual dysfunction. Merck's results of the clinical trials, which can be accessed on the FDA access data website, had patients experience permanent sexual dysfunction after quitting Finasteride. Clinical findings on PFS include depleted neuroactive steroid levels in PFS patients, double the amount of androgen receptors in penile stromal cells, pudendal nerve neuropathy, vascular abnormalities in penile ultrasound. What's the counter-argument? A hair loss clinician, erroneously labeled "scientists" in the entry, claims in a predatory journal that PFS is akin to 15th century witchcraft, mass delusions, and Morgellon's disease, and this somehow meets Wikipedia criteria. Alex, you have proven to be dishonest and I am reporting you to Wikipedia administrators. I bet you're one of those self-styled "skeptics." Your comments wreak of pseudointellectualism. AntiSemanticCanard (talk) 07:37, 1 April 2021 (UTC)
 * All Wikipedia does is report what reliable sources say, with a steady eye on a need to be neutral. It's been evident for many years there are those with a line to push, and who want Wikipedia to reflect that, possibly with an eye to lining their pockets. But that's not how it works. Alexbrn (talk) 08:43, 1 April 2021 (UTC)
 * PFS research has been published by RELIABLE scientists in RELIABLE journals. You know who's trying to "line their pockets?"  Hair restoration surgeons publishing junk articles on PFS denial in predatory journals like "Skin Appendage Disorders."  That's who's trying to "line their pockets."  — Preceding unsigned comment added by AntiSemanticCanard (talk • contribs) 17:51, 1 April 2021 (UTC)
 * Your favorite conspiracy theory that people are here to line their pockets is not only unsubstantiated but disproven. The litigation is irrelevant and has already been settled but even if the litigation were ongoing, Wikipedia would be restricted and less impt than that would be presented in court. It's a real shame what your doing here with whatever your agenda is because will be hurting real people.  I hope you can sleep well with that.  Truly review what was reported in the Reuters investigation and accompanying court testimonies to so you can very clearly see that this is a real medical condition that Merck tried to suppress and you have picked up that baton.  If you think for 3 seconds, you will obviously realize the gravity of what you're doing because it's undeniable at this point what has happened.  You've already misrepresented the Reuters article so you too are burying this safety information just like Merck did and you know it.  This isn't a Wiki battle for your own entertainment, consider the real world impacts of what you're doing to other humans.2603:7000:2400:1E91:5D0:64DC:8A56:D3BA (talk) 13:17, 1 April 2021 (UTC)

Check out the WP:COIN archives to see previous troubles with conflicted editors (now banned) pushing a Finasteride POV. Remember this Talk page is WP:NOTAFORUM and so your personal beliefs about Finasteride are not relevant or welcome, even if you believe they are necessary to WP:RGW. Wikipedia has WP:PAGs which ensure our content is a careful neutral summary of accepted knowledge on subjects, and is fairly well fortified against advocacy. Alexbrn (talk) 13:22, 1 April 2021 (UTC)
 * I checked the COIN archives and not a single case was proven to actually have a COIN. You've been on a witch hunt for years.  Having been harmed by a drug is NOT a conflict of interest.  Neither does anybody here want to right a great wrong.  All I've seen is people who want to fairly update the wiki article to include the evidence that has accumulated over the past decade regarding research into this syndrome.  Obviously, primary sources cannot be included per MEDRS but you've been aggressive diluting this article to meet whatever agenda you have.  It's so clearly spelled out that this is real, and you know it, based on the Reuters investigation which proves that Merck knew about these risks and hid from to prevent losing a ton of money.  This isn't about my belief, I'd like to see this article as balanced as possible based on available information to make this as credible as possible.  But you're delusional if you think this is unsubstantiated after it was unequivocally demonstrated in the investigative report.  How to include this information properly is a separate discussion, but you appear to have no interest in constructively editing this article, at the cost of seriously injuring misinformed consumers. 2603:7000:2400:1E91:5D0:64DC:8A56:D3BA (talk) 14:55, 1 April 2021 (UTC)
 * The "injury" would be to knowledge, and would happen it Wikipedia allowed the kind of spittle-flecked advocacy you're exhibiting. Let's just stick to neutrally reporting what good sources say, and all shall be well. As to suicides, in the Reuters piece which (curiously) wasn't initially used in this article it is stated Merck thought the rate not significant, and Reuters report that the FDA "ultimately agreed with Merck's request on the grounds that the number of suicides was lower than one would expect in this group of patients". I'm guessing this is why the payout in the court cases was so nugatory. It seems finasteride activists vehemently disagree with this, but Wikipedia reports on disputes, it is not a platform for either "side" to use to advocate their cause. Alexbrn (talk) 15:00, 1 April 2021 (UTC)
 * You're clearly not acting in good faith here. I'm not sure what you mean the "injury" would be to knowledge, but if you exclude this from wikipedia which is a common reference, you will be effectively misinforming people.  I haven't even edited the page so it's misleading for you to say I'm advocating towards anything.  The lawsuit, referenced in the first investigative report, was solely based on sexual dysfunction and you're wrongly speculating about what happened in there because you're not on point at all.  This isn't an advocacy issue here, it's about the need to present all information fairly according to Wiki principles which you're not doing.  It seems like you're on a petty Wikipedia power trip, which is your business as to how you want to feel good abt yourself, but you're little game will be hurting other people.  Review the first Reuters article and honestly ask yourself whether Merck knew about persistent sexual side effects and hid them, or they didn't.  The Reuters source is in fact completely referenceable, but I have to check about the underlying filings.  Just be intellectually honest with yourself here because you will be personally responsible for misinforming and injuring people.
 * And while I still have to check on whether its referenceable, go read the testimony with Charlotte Merritt, Merck's head of regulatory affairs, about what she did to mislead the FDA and how she removed the word "all" from the label. Ask yourself if you want to be the Charlotte Merritt of Wikipedia bc she has blood on her hands.2603:7000:2400:1E91:5D0:64DC:8A56:D3BA (talk) 15:38, 1 April 2021 (UTC)
 * You probably need to get to know Graham's hierarchy of disagreement: name calling does not a good argument make, but tends to be quite revealing of the arguer. We cite Reuters news piece, and we cite it accurately. Wikipedia articles should be based on secondary sources. Doing WP:Original research to dig around in court documents and come up with some different narrative more to your taste is verboten. It is not editors' jobs to form opinions on topics (although you plainly have) but to report what good sources say in a disinterested way. I am entirely uninterested in the incidents so I'll leave all the opinion-forming to the likes of you. However, if you want them aired on Wikipedia you'll need to get them published in reliable sources. Alexbrn (talk) 15:49, 1 April 2021 (UTC)
 * This is fine, you're revealing yourself as somebody who clearly isn't intellectually honest as your answer was very evasive. I didn't call you any names whatsoever, but you certainly have insulted editors on here.  It's not digging around to come up with a different narrative, the expose is literally titled "Court let Merck hide secrets about a popular drug’s risks" so you have picked up the baton.  Sleep tight.2603:7000:2400:1E91:5D0:64DC:8A56:D3BA (talk) 16:45, 1 April 2021 (UTC)
 * More silly name calling I see. Headlines are generally not reliable sources, as they're written to sensationalize. If you want to cross the Rubicon and make an actual, source-based proposal rather than rant &amp; rave, then do so. So far: zilch but bluster. Alexbrn (talk) 17:23, 1 April 2021 (UTC)
 * He and others have made plenty of source based proposals. You're the one calling people knowledgeable on the topic "dishonest shills." Then you call a hair restoration surgeon "scientists" and allow pseudoscientific quackery like "mass psychosis" to make it into the entry. AntiSemanticCanard (talk) 17:46, 1 April 2021 (UTC)
 * Another sock. But no source-based proposal or evidence for the crazy claims. Alexbrn (talk) 17:36, 1 April 2021 (UTC)
 * This isn't a sock account. This is AntiSemanticCanards, I forgot to login.  First of all, what "crazy claims" did I not source?  And second of all, why are claims of "mass psychosis" allowed in the PFS wiki, when the claim was made by a hair restoration surgeon (not scientists) in a predatory journal called "Skin Appendage Disorders?"AntiSemanticCanard (talk) 17:46, 1 April 2021 (UTC)
 * The crazy claim is that we're calling a "hair restoration surgeon" (why do I feel this ad hominem form of argumentation is familiar?) "scientists". We are not citing any predatory journals: the shill/junky sources were cleared out. I have no idea what the "PFS Wiki" is - is that your work? Alexbrn (talk) 17:49, 1 April 2021 (UTC)
 * Ralph Michel Trueb is a hair restoration surgeon in Switzerland. He is not a psychiatrist. He is not a scientist. Yet he wrote the junk paper "Post-Finasteride Syndrome: An Induced Delusional Disorder with the Potential of a Mass Psychogenic Illness?" That is the source of claim that PFS is akin to "mass psychosis" and "Morgellon's disease." The paper was published in a predatory journal called "Skin Appendage Disorders." AntiSemanticCanard (talk) 18:08, 1 April 2021 (UTC)
 * We're not citing that. It would only be relevant if it was made respectable by being cited by a reputable secondary source, lending it weight. A quick search seems to suggest that Ralph Michel Trüeb is a professor of dermatology at the University of Zurich. So your calling him "not a scientist" would seem to be a WP:BLP infraction and should be redacted. He is certainly more a scientist that random WP:SOCKs on Wikipedia. But in any case we don't cite his publication so I'm not sure why this is such a focus of anger for you? Alexbrn (talk) 18:12, 1 April 2021 (UTC)
 * Calling Trueb a scientist is a flat-out lie. The claim that Trueb is a scientist should be immediately retracted. Trueb is a deranged dermatologist who wrote a bizarre paper called "Saint Rita of Cascia: Patron Saint for Women with Frontal Fibrosing Alopecia?" You are deceiving the readers by calling him a scientist. AntiSemanticCanard (talk) 18:38, 1 April 2021 (UTC)
 * The article never called him a "scientist", rather it's the several scientists that were cited for the views mentioned. In any case, since you have just committed a WP:BLP violation I strongly suggest you delete your comment before an admin notices. Alexbrn (talk) 19:23, 1 April 2021 (UTC)

The article never called him a scientist because he is not a scientist. Nor is anyone else listed on the junk paper. You are intentionally deceiving Wikipedia readers with the phrase "other scientists," and this will be filed as a complaint to Wikipedia Administrators. AntiSemanticCanard (talk) 19:41, 1 April 2021 (UTC)
 * (add) Also on what basis do you claim Skin Appendage Disorders is a "predatory journal". It is not listed that I can see at WP:CRAPWATCH, and its chief editor seems to be fully aware of the perils of predatory journals. Alexbrn (talk) 18:28, 1 April 2021 (UTC)

Flippant Violation of MEDRS
, this latest edit is out of control. You've obviously been succeeding at dismantling and inverting the content in this entire page by hammering away at every little word, reversing messages, but at times fairly criticizing sources that are not MEDRS compliant. As you are an extremely experienced editor, cherry picking a single sentence in an editorial piece to place it in lede of the article is beyond the pale. It's not even revealing, because anyboyd here can see what you are trying to do, but it's shocking that even you would make such a mistake that flouts wiki guidelines to meet your agenda, whatever that is. I have stayed out of editing this because it is very unpleasant when editors like you act so aggressively to clearly represent a POV that not only dismisses but inappropriately denies post finasteride syndrome. What these editors are looking to do is absolutely not advocacy and apparent by their attempt to include sources that reflect medical arguments in favor and against the existence of wikipedia. The goal here, among these editors, is obviously to update wikipedia to reflect current scientific thinking WITHIN THE BOUNDARIES OF MEDRS SOURCES IN AN ACCURATE AND BALANCED WAY. Advocacy crosses that barrier to attempt to cross and subvery wiki guidelines. But many of these editors here are newbies and you are ripping them to shreds and unwilling to work with them to accomplish a legitimate editorial goal but one they don't understand how to do. I don't even need to do this but this is for other editors to see what you are egregiously flouting - WP:BITE. You seem to be more an advocate of WP:PBTN

You are an extremely experienced editor, obviously know better about how to constructively engage editors (esp new ones) with whom you disagree, and have only demonstrated aggression to antagonize these new editors. With nobody here involved in litigation (because its over), you cannot say there is any kind of COI, as editors are freely allowed to edit on things they've had experiences with so long as they abide by wiki guidelines. These new people do not know how to do that and you have been obstructing their ability to learn by editing aggressively against them. I have not edited this page long time, or the main page in the past couple months, because editors like you have ruined editing Wikipedia for many editors including myself. I'm here passively to see if the editing process is managed fairly and appropriately, and in this has not been whatsoever.

I propose a few options to resolve this unnecessary conflict and maybe you have alternative suggestions: My opinion here, is that it will raise a lot of eyebrows among administrators for reasons I need not explain to you and due to your extensive experience here. But that would be for the admins to decide. I would rather not get them involved because it would unnecessarily use up their resources and introduce unpleasant drama. I think you will raise a lot of eyebrows and likely be censured, but that will be decided by the admins. But maybe we do need that. What happens to you is irrelevant to me, but an uninvolved 3rd party can help synthesize and balance the weighting of the information on here that you seem unwilling to do.
 * You can in good faith work with these newer and some older editors to reach a true consensus that accurately reflects current thinking on post finasteride syndrome within the boundaries of what can be adequately included on wikipedia. For whatever reason you may have, which is totally irrelevant, you seem completely unwilling to do this.  But this is the best option available for everybody, if you really interested in expanding the knowledge and information on this encyclopedia.
 * This page has been seriously degraded, mostly by you, so one option is to agree to just delete this page because this page, if others agree, because this may not be worth reconstructing. But that's not for me to say.  Maybe other Wiki Medicine editors agree with you that this doesn't warrant a stand alone article, that's not for me to say, but that would be a constructive way of dealing with this disagreement.
 * The last and most unpleasant option for everybody would be to file an ANI and get administrators involved. You're involvement here has been beyond questionable as seen from the perspective of any uninvolved and experienced editor.  Especially with your latest introduction of clearly a cherry-picked, MEDRS non-compliant editorial in the lede, especially given somebody of your experience and deep knowledge of MEDRS standards.  These people you allege to be advocates has apparently done their best to accommodate MEDRS standards, but clearly clumsily due to lack of experience and knowledge, so your role here as the more experienced editor is to educate and work with them.

What do you think of this? How do you think will be the best way to proceed? 2603:7000:2400:1E91:9D37:31FA:1306:96B5 (talk) 14:47, 4 April 2021 (UTC)
 * There is no intractable dispute, the issues are decided. As in many similar topics, Wikipedia is not going to bend to WP:ADVOCACY, and neutrality and good sourcing has won through. For wider input from (yet more) uninvolved editors familiar with medical sourcing, I suggest asking at WT:MED. Administrators are aware of what's been happening and have already intervened. More such intervention will probably happen, yes. Alexbrn (talk) 15:10, 4 April 2021 (UTC)
 * That response tells me what I need to know. Will you please answer why you used that one particular sentence from a non-MEDRS compliant editorial in the lede? 2603:7000:2400:1E91:9D37:31FA:1306:96B5 (talk) 15:51, 4 April 2021 (UTC)


 * Multi-author editorials in highly prestigious journals have been called some of our most golden sources for matters of general background on medical topics. For hard bioscience, not so much. Remember the spinning plate of MEDRS. By the way, are you socking by editing logged-out? Alexbrn (talk) 15:56, 4 April 2021 (UTC)
 * That's an absurd inconsistency on your part. There are multi - author editorials in top tier journals on post finasteride syndrome that would provide strong background on the illness, even discuss the data withheld by Merck from the FDA, and nobody has ADVOCATED to put in non-MEDRS sources.  Let me be clear, I am NOT a sock.  You have no evidence to support that I am specifically a sock, and your assumption of bad faith shows that you are unwilling to cooperate.  I am completely allowed to edit under an IP address and I have voluntarily told you that I have not edited the pages because its not a nice experience to try and work with editors like you.  Fine.  I would have liked to constructively cooperate with you, but this latest interaction with you assuming bad faith on my part without and your puzzling cherry picking of a non-compliant MEDRS source shows that I have no partner to work with and will seek out the assistance of uninvolved parties. 2603:7000:2400:1E91:9D37:31FA:1306:96B5 (talk) 16:22, 4 April 2021 (UTC)
 * "There are multi - author editorials in top tier journals on post finasteride syndrome" &larr; doubt it. I searched and didn't find anything in The Lancet or NEJM. But perhaps I missed something? The reason I ask about socking is that you write above "I have not edited this page long time, or the main page in the past couple months". But your IP has never edited the main (i.e. Finasteride) page ... which suggests multiple identities are in play. If you have an account, you shouldn't edit as an IP as it evades necessary WP:SCRUTINY. Alexbrn (talk) 16:32, 4 April 2021 (UTC)
 * BMJ is top-tier and they did an editorial on PFS. You even cited it yourself in order to label PFS 'controversial.' (As if putting that twice in the introduction isn't redundant) AntiSemanticCanard (talk) 18:52, 4 April 2021 (UTC)
 * I'm putting this on the record for 3rd parties to review, but no I do not have an account. I edit on an IP account, which is completely allowed and why Wiki does not require you create one.  I guess it is dynamic and changes over time.  I am not going to edit the main page anyway, so its a moot page.  There are editorials Yes, there are editorials.  A recent one that comes to mind is JAMA Dermatology but there are editorials. But that BMJ editorial happens to be far more supportive of evidence that PFS exists that you represented in a narrow sentence fragment.  The article outright says we KNOW that finasteride inhibits neurosteroids, a claim that you or others have removed have removed from the articles many times, despite being in a medical textbook.  The editorial mentions that 17 governmental regulatory agencies have updated their labels to include warnings of sexual side effects or depression, a claim that you conveniently omitted and has been removed from the article many times.  I have no interest in fighting or arguing with you, it seems like a lot of long time editors get a thrill out of that.  I think the encyclopedia has a large blindspot regarding this important issue and the article(s) should be appropriately updated to include all the qualifying reliable sources (not editorials) with fair and balanced and neutral information.  This is my last response to you since you will not engage with me constructively and seem to enjoy conflict so please don't respond or at least don't expect a response from me here. 2603:7000:2400:1E91:9D37:31FA:1306:96B5 (talk) 16:58, 4 April 2021 (UTC)
 * The editorial: "" is generally sympathetic to the idea that finasteride side-effects are more than have been reported, but is very careful in its wording, and does not mention the term "post-finasteride syndrome". It states, highlighting the problem of reporting adverse-events, and the lack of robust data: "The extent to which finasteride-related sexual impairment can be persistent is not clearly reported in any of the standard sources". It also mentions "A patient group is also active and promoting resarch". The editorial refers to a meta-analysis that supports that adverse events were inadequately monitored in finasteride trials, and their reporting may have been biased. This is interesting, but not enough to support a stand-alone article. NikosGouliaros (talk) 17:35, 4 April 2021 (UTC)
 * I was looking at . It may be useful for some background (e.g. about media interest) if/when this article's content gets merged to the parent. Alexbrn (talk) 17:37, 4 April 2021 (UTC)
 * I am speaking directly to Nikos here or other editors willing to be constructive and not obstructionist. This whole idea about including editorials is a complete reversal from what established editors have treated medical sources on this page and others.  Editorials are not discussed in MEDRS.  There are other editorials, but the recent JAMA Dermatology editorial I was thinking of is https://jamanetwork.com/journals/jamadermatology/article-abstract/2772815.  The first sentence states, "Since its approval for the treatment of male-pattern androgenetic alopecia by the United States Food and Drug Administration in 1997, finasteride has continued to be at the center of many controversies regarding its adverse events. Although sexual adverse events were included in the original label of finasteride, little attention was initially paid to the 2002 elimination of the word “all” in the drug monograph1 regarding sexual adverse events, changing the language from “resolution occurred in all men who discontinued therapy” to “resolution occurred in men who discontinued therapy.”  This information was similarly, removed from this side page and the main page.  And extremely material because by any objective person's standards it showed the manufacturer sneakily tried to change the labeling to avoid detection by consumers and doctors.  The new text wasn't even misleading, it was false, as any person will tell you.  The standards that have been applied on this article and the other are extremely inconsistent when it comes to these sorts of things and it would be nice to work with somebody like you to get it sorted out.  This editorial happens to be fairly balanced in representing the state of public medical discussion about PFS.  Although I still am questioning why AlexBRN is trying to introduce an editorials now, I have never seen anybody even try to do this until just now, these more balanced perspectives are simply not included in Wikipedia and have never been to my knowledge. There have been many obstructionist editors who reactively pull the article back to older states and even espouse a rejectionist view of post finasteride syndrome without reaching consensus.  But you've made fair and constructive criticisms so it would be nice to discuss this with you.  Will you please clarify your understanding/position on whether editorials are valid and how they should be used?  Another editor here submitted this article, so I don't want to speak for them, but it seems like most people don't like this page.  Do you think it makes sense to just delete this page and hammer out existing and new details on the main finasteride page? We could also work to fix up this one but you don't seem to be of the opinion that this is worth a standalone article, which seems to what most people think.2603:7000:2400:1E91:9D37:31FA:1306:96B5 (talk) 18:11, 4 April 2021 (UTC)

I love the image to the right with the caption: "Reliable sources must be strong enough to support the claim. A lightweight source may sometimes be acceptable for a lightweight claim, but never for an extraordinary claim." How about we apply that same logic to claims of PFS being mass psychosis made by non-scientists who have a history of writing quack papers? AntiSemanticCanard (talk) 19:00, 4 April 2021 (UTC)
 * Editor got blocked. But in any case Wikipedia does not claim "PFS is mass psychosis", but merely reports this is what some scientists have said, using a decent quality WP:MEDRS review article as reference. I'm sorry, but WP:ADVOCACY is not going to prevail against honest encyclopedic content. Alexbrn (talk) 19:19, 4 April 2021 (UTC)
 * , will you please take look at my most recent msg above and respond if you have any thoughts to what you think about including editorial info on Wiki (not mentioned in MEDRS) and what you think would be the best way to proceed with this topic? Thanks.  2603:7000:2400:1E91:9D37:31FA:1306:96B5 (talk) 14:17, 5 April 2021 (UTC)
 * I feel the need to thank you, IP, for the nice things you mention about me, although none of it is necessary: I need no special invitation to contribute to the discussion. In any case, I don't have much more to add. I do sometimes wander what a consensus position would be on editorials as medical sources in Wikipedia; there being none for now, I suppose we must decide on a case-by-case basis (the exception being that, clearly, an editorial cannot be considered a secondary source as regards findings from the very study that it's related to; I mean, in the same journal issue). None of the editorials I've read from JAMA Derm change my view that "post-finasteride syndrome" has no reason to be a stand-alone article, or incline me to propose any change to the article as it is currently. NikosGouliaros (talk) 19:26, 5 April 2021 (UTC)
 * , I understand, it seems pretty clear that the community doesn't seem to support this remaining as a standalone page. Perhaps at some point in the future as the research process continues to unfold.  As mentioned in the Jama editorial, little attention was given to the fact that the product warning label was changed in 2002 where the manufacturer inconspicuously removed "all" from "resolution occurred in all men who discontinued therapy".  This is also mentioned in the Reuters article but was removed from the main page and I think it's sufficiently notable by wiki standards and public standards to put it back in.  Other than that, would it make sense to delete this article for now until more research comes out?, since you submitted this page for creation, do you have an opinion on deleting this page? 98.7.49.47 (talk) 04:46, 7 April 2021 (UTC)

Drafting a new article for PFS
Hi, I would like to take a stab at drafting a new article for this topic; as of the present, I personally believe PFS has been sufficiently discussed in the media and acknowledged by enough credible medical sources to warrant its own Wikipedia article, although I fully acknowledge the nature/existence of PFS remains contentious. I recently drafted an article for post-SSRI sexual dysfunction (PSSD) which was approved for publication, and I believe the existence of PFS to be at least as well-supported as PSSD, if not more so. I believe I am capable of drafting an article that provides an informative and impartial discussion of PFS, as I hope I have been able to do with PSSD.

Would it be possible to lift the protection on this page so that I can draft an article? Or is there some other way I can write and submit a draft while the page remains protected? Xardwen (talk) 08:14, 3 June 2023 (UTC)