I've been on enzalutamide a little over a year now. It does the trick. My PSA has been undetectable until recently - and that's on two pills a day. I started out with four but needed my brain to earn a living (I'm an engineer).
I'm a fitness guy. I road bike, mountain bike, or lift weights in the gym almost every day. After all these years bike riding, I had my first serious OTB (over the bars) recently. Broke my wrist in two places and my ribs in four. With the relative inactivity (hiking and swimming didn't seem to cut it) gynecomastia swelled up. Growing boobs hurts! (and my wife and daughters have no sympathy). Between the boobs and the hot flashes, I'm well on my way to way womanhood.
I talked to my doctor into a trial of tamoxifen (a selective estrogen receptor modulator used for breast cancer) at 20 mg per day. Even though there is an enzalutamide CYP3A4 interaction (which causes the bulk of the tamoxifen to wash out), I'm happy with the results so far. I'm going to try to get 40 mg next.
My reason for writing though, is I think I stumbled on something else significant. It's a big deal for me anyway.
The CNS (central nervous system) effects from enzalutamide stem from an off target interaction with the GABA-A receptor. The same general area where Ambien and alcohol play. I tried modafinil and caffeine to offset it. The wonkyness (my term) was there regardless of how stimulated I was.
On one particularly wonky morning I was banging on the Google, determined to find something else that would mess with the GABA-A receptor. How have I missed this for a year? L-Theanine! Looks like it's going in the right direction. My wife likes the stuff for her chronic fatigue and anxiety - there's a whole bottle in the cabinet. I pop 4 and wait to see what happens.
It felt like the curtains opened and the lights came on. Whoa! On a day for which I knew I had poor sleep, this was amazing! I found myself walking around with a shit eating grin. I'm back!
It's been three weeks now. I take 100 mg L theanine roughly every three hours. I've upped the ENZA to 3 and feel great. I'm having fun with my brain. I see the Onco next Tuesday. I'll see what the labs tell me, and then try a full dose of 4 enzalutamide.
I've been almost afraid to say anything to anyone for fear that this isn't real. If it's placebo - it's a good one!