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479 Another cascade linking astrocytes to the pathophysiology of Down syndrome is an increased production of hydrogen sulphide, which is catalysed by cystathionine--synthase expressed, more or less exclusively, in astrocytes, and upregulated in a rat model of the disease

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It may be time to consider switching to a 5alpha-reductase inhibitor

Mitchell KG, Diao L, Karpinets T, Negrao MV, Tran HT, Parra ER, Corsini EM, Reuben A, Federico L, Bernatchez C, Dejima H, Francisco-Cruz A, Wang J, Antonoff MB, Vaporciyan AA, Swisher SG , Cascone T, Wistuba II, Heymach JV, Gibbons DL, Zhang J, Haymaker CL, Sepesi B