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Re: Depression/ADD and Testosterone treatment

Posted by ayrity on January 8, 2003, at 11:05:42

In reply to Re: Depression/ADD and Testosterone treatment, posted by Larry Hoover on January 8, 2003, at 8:15:05

Thanks, Larry.
Interesting study. Unfortunately, the abstract does not state the actual number of men with improvement, or the level of statistical significance between the study and control populations. I'll have to look up the full journal article and see for myself.

The key point is that these men had low, or low-normal, testosterone levels. I think men who have T levels in the normal range need to be cautious. I can't function without T treatment because my body essentially does not make any. However, long-term treatment with T might have adverse consequences for those who already have normal range levels- possible liver effects, possible increased risk of prostate cancer (apparently not in men with absolute deficiency but who knows for those with levels in the normal range), gynecomastia, acne, hair loss, etc, etc.

I think more studies are needed, but this is a start. Remember all the push towards hormone replacment therapy in postmenopausal women? Now there's a backlash. Hormone treatment needs to be researched, but real caution is indicated before this sort of treatment is generally prescribed.

> Hot off the presses:
> Am J Psychiatry 2003 Jan;160(1):105-11
> Testosterone gel supplementation for men with refractory depression: a randomized, placebo-controlled trial.
> Pope HG Jr, Cohane GH, Kanayama G, Siegel AJ, Hudson JI.
> OBJECTIVE: Testosterone supplementation may produce antidepressant effects in men, but until recently it has required cumbersome parenteral administration. In an 8-week randomized, placebo-controlled trial, the authors administered a testosterone transdermal gel to men aged 30-65 who had refractory depression and low or borderline testosterone levels. METHOD: Of 56 men screened, 24 (42.9%) displayed morning serum total testosterone levels of 350 ng/dl or less (normal range=270-1070). Of these men, 23 entered the study. One responded to an initial 1-week single-blind placebo period, and 22 were subsequently randomly assigned: 12 to 1% testosterone gel, 10 g/day, and 10 to identical-appearing placebo. Each subject continued his existing antidepressant regimen. Ten subjects receiving testosterone and nine receiving placebo completed the 8-week trial. RESULTS: The groups were closely matched on baseline demographic and psychiatric measures. Subjects receiving testosterone gel had significantly greater improvement in scores on the Hamilton Depression Rating Scale than subjects receiving placebo. These changes were noted on both the vegetative and affective subscales of the Hamilton Depression Rating Scale. A significant difference was also found on the Clinical Global Impression severity scale but not the Beck Depression Inventory. One subject assigned to testosterone reported increased difficulty with urination, suggesting an exacerbation of benign prostatic hyperplasia; no other subject reported adverse events apparently attributable to testosterone. CONCLUSIONS: These preliminary findings suggest that testosterone gel may produce antidepressant effects in the large and probably underrecognized population of depressed men with low testosterone levels.




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