I’m going to preface my response with this so we can all be more informed. There’s good information in here, though I do not know if it has been disputed… this isn’t a topic I frequent.
For conciseness, I’ll restate what you said:
Your PSA going down from 4.5 to 3.5 (I believe the range you want is 1-3)… Was the drop to 3.5 before or during finasteride intervention?
For reference: if it were over 10, there is a 50% chance of prostate cancer, according to google.
If my understanding is correct, your provider wants to shrink your prostate down by further blocking DHT in hopes your prostate will eventually shrink. Google says it typically takes 3-6 months for this to happen, under the assumption that high DHT levels are what caused your enlarged prostate - which we don’t know. Again, there are some gripes with the claim that high DHT leads to prostate enlargement, so we don’t know how valid those concerns are.
Has your urologist lowered your test dose alongside finasteride treatment? It seems a logical approach that if high DHT were the problem, reducing the drug providing your DHT could be a good resolution.
RE Depressive symptoms…
Are you just feeling blue, or are there suicidal thoughts?
For legal reasons, you probably shouldn’t answer directly if it’s the latter of these, but you SHOULD absolutely talk to your provider if this is the case.
If it’s the former, do you think you could just deal with the depressive symptoms for the next couple months until treatment is over?