Psycho-Babble Medication Thread 134881

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Depression/ADD and Testosterone treatment

Posted by DiscoPuppy on January 7, 2003, at 18:25:24

Hi Everyone-

Lately, I've seen quite a few print ads for this prescription "cream" of some sort for people who are testosterone deficient. It lists several indications, all of which I have.

Then it suddenly dawned on me. Maybe I was headed the wrong directions with all of those endless psychiatrists with an infinite supply of various antidepressants and ADD meds, when all I needed to see was an endocrinologist.

Among the plethora of symptoms the ad for this medication (I think it was Adrio gel or something like that), they mention fatigue, depression, diminished libido, inability to concentrate, etc. Up until now, I have taken Zoloft, Paxil, Effexor and Celexa for the depression and Adderall and Dexedrine for ADD, all with NO SUCCESS.

Has anyone, particularly the men out there, tried any type of a testosterone-replacement therapy to treat depression and/or ADD? If so, how were the results?

I'm planning on seeing an endocrinologist soon to have my testosterone level checked. I'm hoping that this is the answer that I've been looking for all these years.

 

Re: Depression/ADD and Testosterone treatment

Posted by ayrity on January 8, 2003, at 0:04:31

In reply to Depression/ADD and Testosterone treatment, posted by DiscoPuppy on January 7, 2003, at 18:25:24

Disco:
I have a rare endocrine condition and need to take testosterone injections.

The testosterone issue has really been hyped-up in the media lately and is mostly a marketing ploy and health fad (somewhat annoying to those of us who actually need to take it). That being said, **true** testosterone deficiency can indeed cause fatigue, depression and other symptoms. I definitely can feel fatigued and more depressed when I am due for an injection, as do others I have spoken to with the same condition.

I would suggest you have your testosterone level checked before jumping to any conclusions. If it realy is low, you might indeed benefit from treatment.

(btw, I take injections and don't use the cream partly out of habit- I've been doing this a long time and the cream only recently came on the market in the past few years- and also because the absorption of the medication from the cream might not be adequate for someone with severe deficiency like me).


> Hi Everyone-
>
> Lately, I've seen quite a few print ads for this prescription "cream" of some sort for people who are testosterone deficient. It lists several indications, all of which I have.
>
> Then it suddenly dawned on me. Maybe I was headed the wrong directions with all of those endless psychiatrists with an infinite supply of various antidepressants and ADD meds, when all I needed to see was an endocrinologist.
>
> Among the plethora of symptoms the ad for this medication (I think it was Adrio gel or something like that), they mention fatigue, depression, diminished libido, inability to concentrate, etc. Up until now, I have taken Zoloft, Paxil, Effexor and Celexa for the depression and Adderall and Dexedrine for ADD, all with NO SUCCESS.
>
> Has anyone, particularly the men out there, tried any type of a testosterone-replacement therapy to treat depression and/or ADD? If so, how were the results?
>
> I'm planning on seeing an endocrinologist soon to have my testosterone level checked. I'm hoping that this is the answer that I've been looking for all these years.

 

Re: Depression/ADD and Testosterone treatment

Posted by Larry Hoover on January 8, 2003, at 8:15:05

In reply to Depression/ADD and Testosterone treatment, posted by DiscoPuppy on January 7, 2003, at 18:25:24

> Hi Everyone-
>
> Lately, I've seen quite a few print ads for this prescription "cream" of some sort for people who are testosterone deficient. It lists several indications, all of which I have.
>
> Then it suddenly dawned on me. Maybe I was headed the wrong directions with all of those endless psychiatrists with an infinite supply of various antidepressants and ADD meds, when all I needed to see was an endocrinologist.
>
> Among the plethora of symptoms the ad for this medication (I think it was Adrio gel or something like that), they mention fatigue, depression, diminished libido, inability to concentrate, etc. Up until now, I have taken Zoloft, Paxil, Effexor and Celexa for the depression and Adderall and Dexedrine for ADD, all with NO SUCCESS.
>
> Has anyone, particularly the men out there, tried any type of a testosterone-replacement therapy to treat depression and/or ADD? If so, how were the results?
>
> I'm planning on seeing an endocrinologist soon to have my testosterone level checked. I'm hoping that this is the answer that I've been looking for all these years.

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.


 

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.

 

Re: Depression/ADD and Testosterone treatment

Posted by jrbecker on January 8, 2003, at 12:23:52

In reply to Re: Depression/ADD and Testosterone treatment, posted by ayrity on January 8, 2003, at 11:05:42

I tried a very low dose of testosterone supplementation (both the Androgel and the injections) for 8 months. An endocrinologist said that I barely fit the criterion for borderline hypogonadism, so I decided to give it a shot. The T definitely helped my my energy level, my focus, anxiety, as well my mood (in order of descending effectiveness). I suffer from atypical depression and so it was really a great boost to the low dose of Celexa I was already on. Is it superior to most ADs in terms of efficacy? Definitely not, although it definitely enhanced my mood a great deal.

Fortunately, I did not have any issues of increased aggression while on it (although I took a very low dose). The eventual reasons for stopping the treatment was the fact that I thought I really didn't need it anymore since my atypical symptoms are much more under control due to a less stressful and healthier lifestyle these days. Also, I recognize that my real issues of low energy lie in an impaired HPA axis, and that having low testosterone was only a side issue to my troubles. Another reason I gave it up was that I saw some slight thinning of my hairline (doesn't happen with everyone though) as well. The biggest downside of it was actually withdrawing from it though. It was one of the worst depressive episodes of my life. Even non-depressed people have a hard time getting off of it, so imagine how hard it is for us depressives.

So, I DO NOT recommend just anyone going and trying this. The only way to see if this would really benefit you is if you actually have low levels of testoseterone to begin with. Next time you visit your practionner, have him take a blood test to see how your T levels are. A lot of the hype has overblown the bad side of testosterone, most of the effects are quite subtle if taken in moderate doses. However, I do concede to it being a very powerful drug (and has been shown to be addictive) so be cautious in considering this treatment option.

Another thing, if you are bipolar, T treatment has been shown to induce mania.

 

Re: Depression/ADD and Testosterone treatment

Posted by OddipusRex on January 9, 2003, at 8:18:29

In reply to Re: Depression/ADD and Testosterone treatment, posted by ayrity on January 8, 2003, at 11:05:42

A short article about the study from the NYTimes

--------------------------------------------------------------------------------

January 7, 2003
Mental Health: Lifting Men's Fog of Depression
By JOHN O'NEIL


Men whose depression does not respond to medication should have their testosterone levels checked, a preliminary study conducted at Harvard suggests.

In the study, published in the January issue of The American Journal of Psychiatry, 12 such men were treated with testosterone gel and 10 with a placebo. Three of the men who were given the testosterone showed significant improvement, and most of the others registered at least some improvement.

Dr. Harrison G. Pope Jr., the study's lead author, said that the results were too inconsistent and that the study size was too small to draw any real conclusions about testosterone as a treatment for depression. The study's most significant finding, he said, came during an early stage, when potential subjects were being screened.

Earlier research, he said, indicated that about 10 percent of depressed men had low or borderline testosterone levels. But when his team screened a group of men whose depression had failed to respond to treatment, they found that almost half of them had low levels.

Dr. Pope said this suggested a possible link between testosterone and the functioning of antidepressants in men. It also showed that low levels of testosterone might be more common than thought among men who did not respond to treatment, he said.

At the least, Dr. Pope said, psychiatrists should order tests of testosterone levels for men who do not respond to antidepressants and consider a course of supplements while more research is conducted.

Copyright 2003 The New York Times Company |

> >
> > 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.

 

Re: Depression/ADD and Testosterone treatment

Posted by DiscoPuppy on January 9, 2003, at 9:53:08

In reply to Re: Depression/ADD and Testosterone treatment, posted by OddipusRex on January 9, 2003, at 8:18:29

Thanks so much for all your information guys. I appreciate the time you all put into a thoughtful answer. My appointment with my endocrinologist is next week so I'll know more for sure then.

 

Re: Depression/ADD and Testosterone treatment

Posted by wild_0ne on January 16, 2003, at 23:52:27

In reply to Re: Depression/ADD and Testosterone treatment, posted by jrbecker on January 8, 2003, at 12:23:52

I had my testosterone tested and I had quite low Total Testosterone, but my Free Androgen Index was normal. I didn't realize that this was the important indicator and that I shouldn't take replacement therapy, but I did by pressuring my GP, and it has thrown me into a horrible depression as well. I think it's the only reason why I have depression as everything else in my life (in hindsight) was pretty good until taking this stuff. I would HIGHLY recommend not taking it unless absolutley necessary and then only if you are under proper supervision!!

> I tried a very low dose of testosterone supplementation (both the Androgel and the injections) for 8 months. An endocrinologist said that I barely fit the criterion for borderline hypogonadism, so I decided to give it a shot. The T definitely helped my my energy level, my focus, anxiety, as well my mood (in order of descending effectiveness). I suffer from atypical depression and so it was really a great boost to the low dose of Celexa I was already on. Is it superior to most ADs in terms of efficacy? Definitely not, although it definitely enhanced my mood a great deal.
>
> Fortunately, I did not have any issues of increased aggression while on it (although I took a very low dose). The eventual reasons for stopping the treatment was the fact that I thought I really didn't need it anymore since my atypical symptoms are much more under control due to a less stressful and healthier lifestyle these days. Also, I recognize that my real issues of low energy lie in an impaired HPA axis, and that having low testosterone was only a side issue to my troubles. Another reason I gave it up was that I saw some slight thinning of my hairline (doesn't happen with everyone though) as well. The biggest downside of it was actually withdrawing from it though. It was one of the worst depressive episodes of my life. Even non-depressed people have a hard time getting off of it, so imagine how hard it is for us depressives.
>
> So, I DO NOT recommend just anyone going and trying this. The only way to see if this would really benefit you is if you actually have low levels of testoseterone to begin with. Next time you visit your practionner, have him take a blood test to see how your T levels are. A lot of the hype has overblown the bad side of testosterone, most of the effects are quite subtle if taken in moderate doses. However, I do concede to it being a very powerful drug (and has been shown to be addictive) so be cautious in considering this treatment option.
>
> Another thing, if you are bipolar, T treatment has been shown to induce mania.


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