Testosterone Replacement Therapy for Anxiety

Testosterone Replacement Therapy for Anxiety

Joined: April 1st, 2004, 4:56 pm

September 3rd, 2007, 12:12 pm #1

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<EM><FONT size=5>1884 </FONT></EM></B></FONT><FONT face=OceanSansMM-It_310_800_><EM><FONT size=5>Am J Psychiatry 157:11, November 2000</FONT></EM>
</FONT><FONT face=verdana,geneva,arial,sans-serif size=4>
<STRONG>Testosterone Replacement Therapy for Anxiety</STRONG>
</FONT>
<FONT size=4><FONT face=verdana,geneva,arial,sans-serif>T</FONT><FONT face=verdana,geneva,arial,sans-serif>O THE EDITOR</FONT><FONT face=verdana,geneva,arial,sans-serif>: We report the case of a patient with previously</FONT></FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>undiagnosed hypogonadism whose anxiety symptoms improved</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>after he received testosterone injections.</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>Mr. A, a 34-year-old man, was diagnosed with generalized</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>anxiety disorder. His symptoms included mental exhaustion,</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>irritability, insomnia, poor concentration, and</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>decreased libido. He unsuccessfully tried relaxation techniques</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>and biofeedback before beginning treatment with</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>buspirone, 30 mg/day. After noticing improvement, he</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>discontinued the medication after 2 months but resumed</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>taking it 6 months later, when his anxiety returned.</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>A review of his medical record indicated that Mr. A had</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>undergone a right orchiectomy several years earlier for an</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>undescended testicle. Blood samples were taken for laboratory</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>analysis. His testosterone level was 185 ng/dl (normal=</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>241–827), and his free testosterone level was 8.9 pg/</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>ml (normal=18–39). His luteinizing hormone level was</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>18.7 mIU/ml (normal=2–12), and his level of follicle-stimulating</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>hormone was 31.4 mIU/ml (normal=1–8). The results</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>of a physical examination and laboratory tests were</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>within normal limits. Mr. A tapered his buspirone treatment</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>and elected not to begin treatment with paroxetine.</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>Mr. A was referred to an endocrinologist, who ruled out</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>occult malignancy and prescribed testosterone enanthate,</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>200 mg i.m. every 2 weeks. He reported resolution</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>of his anxiety symptoms after 1 month. His concentration</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>and libido increased, and he reported better orgasms. He</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>tried to decrease the frequency of his injections but remained</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>on the bimonthly schedule after feeling his anxiety</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>symptoms returning. He has been on the regimen for</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>more than 18 months and has experienced no side effects.</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>This treatment plan may be continued indefinitely.</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>Contraindications to androgen replacement therapy include</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>androgen-dependent cancers, such as prostate and</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>male breast cancer, and benign prostatic hypertrophy when</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>obstructive symptoms are present (1). A patient’s hematocrit</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>and low-density/high-density lipoprotein ratio should be</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>monitored, since testosterone can elevate these as well (1).</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>The literature supports a connection between hypogonadism</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>and depression, as evidenced by untreated hypogonadal</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>men scoring significantly higher in ratings of depression,</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>anger, fatigue, and confusion than infertile and normal</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>comparison men (2) and by the improvement of depressive</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>symptoms after the administration of testosterone to hypogonadal</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>men with depression refractory to selective serotonin</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>reuptake inhibitors (3). Another study (4) has shown that testosterone</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>replacement therapy decreases anger, nervousness,</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>and irritability in hypogonadal men. The temporal connection</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>between the improvement of Mr. A’s anxiety symptoms</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>and replacement testosterone suggests an association between</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>anxiety and hypogonadism. With this case report, we</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>suggest including anxiety in the list of psychiatric manifestations</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>of hypogonadism that improve with testosterone replacement</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>therapy.</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>References</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>1. Wang C, Swerdloff R: Androgen replacement therapy. Ann Med</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>1997; 29:365–370</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>2. Burris A, Banks S, Carter S, Davidson J, Sherins R: A long-term,</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>prospective study of the physiologic and behavioral effects of</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>hormone replacement in untreated hypogonadal men. J Androl</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>1992; 13:297–304</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>3. Seidman SN, Rabkin JG: Testosterone replacement therapy for</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>hypogonadal men with SSRI-refractory depression. J Affect Disord</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>1998; 48:157–161</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>4. Wang C, Alexander G, Berman N, Salshian B, Davidson T, Mc-</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>Donald V, Steiner B, Hull L, Callegari C, Swerdloff RS: Testosterone</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>replacement therapy improves mood in hypogonadal</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>men: a clinical research center study. J Clin Endocrinol Metab</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>1996; 81:3578–3583</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>MARC A. COOPER, M.D.</FONT>

<FONT face=verdana,geneva,arial,sans-serif size=4>ELSPETH CAMERON RITCHIE, M.D.</FONT>
<FONT face=OceanSansMM-It_403_800_ size=1>
<FONT face=verdana,geneva,arial,sans-serif size=4>Washington, D.C.</FONT>
</FONT>
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Joined: April 1st, 2004, 4:56 pm

September 3rd, 2007, 12:12 pm #2

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September 3rd, 2007, 12:22 pm #3


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<P class=content-hdr>reference values (testosterone)
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nmol/L

11-36 males 0.8-3.1 females

Note that reference ranges may vary between laboratories.
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    Joined: April 1st, 2004, 4:56 pm

    September 3rd, 2007, 12:31 pm #4

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    <H2 class=r><FONT color=#551a8b>Letters to the Editor</FONT></H2>

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    <EM><FONT size=5>1884 </FONT></EM></B></FONT><FONT face=OceanSansMM-It_310_800_><EM><FONT size=5>Am J Psychiatry 157:11, November 2000</FONT></EM>
    </FONT><FONT face=verdana,geneva,arial,sans-serif size=4>
    <STRONG>Testosterone Replacement Therapy for Anxiety</STRONG>
    </FONT>
    <FONT size=4><FONT face=verdana,geneva,arial,sans-serif>T</FONT><FONT face=verdana,geneva,arial,sans-serif>O THE EDITOR</FONT><FONT face=verdana,geneva,arial,sans-serif>: We report the case of a patient with previously</FONT></FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>undiagnosed hypogonadism whose anxiety symptoms improved</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>after he received testosterone injections.</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>Mr. A, a 34-year-old man, was diagnosed with generalized</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>anxiety disorder. His symptoms included mental exhaustion,</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>irritability, insomnia, poor concentration, and</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>decreased libido. He unsuccessfully tried relaxation techniques</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>and biofeedback before beginning treatment with</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>buspirone, 30 mg/day. After noticing improvement, he</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>discontinued the medication after 2 months but resumed</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>taking it 6 months later, when his anxiety returned.</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>A review of his medical record indicated that Mr. A had</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>undergone a right orchiectomy several years earlier for an</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>undescended testicle. Blood samples were taken for laboratory</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>analysis. His testosterone level was 185 ng/dl (normal=</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>241–827), and his free testosterone level was 8.9 pg/</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>ml (normal=18–39). His luteinizing hormone level was</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>18.7 mIU/ml (normal=2–12), and his level of follicle-stimulating</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>hormone was 31.4 mIU/ml (normal=1–8). The results</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>of a physical examination and laboratory tests were</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>within normal limits. Mr. A tapered his buspirone treatment</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>and elected not to begin treatment with paroxetine.</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>Mr. A was referred to an endocrinologist, who ruled out</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>occult malignancy and prescribed testosterone enanthate,</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>200 mg i.m. every 2 weeks. He reported resolution</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>of his anxiety symptoms after 1 month. His concentration</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>and libido increased, and he reported better orgasms. He</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>tried to decrease the frequency of his injections but remained</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>on the bimonthly schedule after feeling his anxiety</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>symptoms returning. He has been on the regimen for</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>more than 18 months and has experienced no side effects.</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>This treatment plan may be continued indefinitely.</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>Contraindications to androgen replacement therapy include</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>androgen-dependent cancers, such as prostate and</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>male breast cancer, and benign prostatic hypertrophy when</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>obstructive symptoms are present (1). A patient’s hematocrit</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>and low-density/high-density lipoprotein ratio should be</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>monitored, since testosterone can elevate these as well (1).</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>The literature supports a connection between hypogonadism</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>and depression, as evidenced by untreated hypogonadal</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>men scoring significantly higher in ratings of depression,</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>anger, fatigue, and confusion than infertile and normal</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>comparison men (2) and by the improvement of depressive</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>symptoms after the administration of testosterone to hypogonadal</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>men with depression refractory to selective serotonin</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>reuptake inhibitors (3). Another study (4) has shown that testosterone</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>replacement therapy decreases anger, nervousness,</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>and irritability in hypogonadal men. The temporal connection</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>between the improvement of Mr. A’s anxiety symptoms</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>and replacement testosterone suggests an association between</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>anxiety and hypogonadism. With this case report, we</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>suggest including anxiety in the list of psychiatric manifestations</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>of hypogonadism that improve with testosterone replacement</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>therapy.</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>References</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>1. Wang C, Swerdloff R: Androgen replacement therapy. Ann Med</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>1997; 29:365–370</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>2. Burris A, Banks S, Carter S, Davidson J, Sherins R: A long-term,</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>prospective study of the physiologic and behavioral effects of</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>hormone replacement in untreated hypogonadal men. J Androl</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>1992; 13:297–304</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>3. Seidman SN, Rabkin JG: Testosterone replacement therapy for</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>hypogonadal men with SSRI-refractory depression. J Affect Disord</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>1998; 48:157–161</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>4. Wang C, Alexander G, Berman N, Salshian B, Davidson T, Mc-</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>Donald V, Steiner B, Hull L, Callegari C, Swerdloff RS: Testosterone</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>replacement therapy improves mood in hypogonadal</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>men: a clinical research center study. J Clin Endocrinol Metab</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>1996; 81:3578–3583</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>MARC A. COOPER, M.D.</FONT>

    <FONT face=verdana,geneva,arial,sans-serif size=4>ELSPETH CAMERON RITCHIE, M.D.</FONT>
    <FONT face=OceanSansMM-It_403_800_ size=1>
    <FONT face=verdana,geneva,arial,sans-serif size=4>Washington, D.C.</FONT>
    </FONT>
    http://ajp.psychiatryonline.org/cgi/con ... 57/11/1884

    <IMG height=56 alt="The American Journal of Psychiatry" src="http://ajp.psychiatryonline.org/icons/h ... terior.gif" width=760 border=0>

    <FONT size=2>Am J Psychiatry 157:1884, November 2000
    © 2000 </FONT><FONT color=#004586 size=2>American Psychiatric Association</FONT><FONT size=2>
    </FONT>
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    Letter to the Editor</TD></TR></TBODY></TABLE>

    Testosterone Replacement Therapy for Anxiety
    <STRONG>MARC A. COOPER, M.D. and ELSPETH CAMERON RITCHIE, M.D.
    <EM>Washington, D.C.</EM> </STRONG>

    To the Editor: We report the case of a patient with previously undiagnosed hypogonadism whose anxiety symptoms improved after he received testosterone injections.
    Mr. A, a 34-year-old man, was diagnosed with generalized anxiety disorder. His symptoms included mental exhaustion, irritability, insomnia, poor concentration, and decreased libido. He unsuccessfully tried relaxation techniques and biofeedback before beginning treatment with buspirone, 30 mg/day. After noticing improvement, he discontinued the medication after 2 months but resumed taking it 6 months later, when his anxiety returned.
    A review of his medical record indicated that Mr. A had undergone a right orchiectomy several years earlier for an undescended testicle. Blood samples were taken for laboratory analysis. His testosterone level was 185 ng/dl (normal=241–827), and his free testosterone level was 8.9 pg/ml (normal=18–39). His luteinizing hormone level was 18.7 mIU/ml (normal=2–12), and his level of follicle-stimulating hormone was 31.4 mIU/ml (normal=1–8). The results of a physical examination and laboratory tests were within normal limits. Mr. A tapered his buspirone treatment and elected not to begin treatment with paroxetine.
    Mr. A was referred to an endocrinologist, who ruled out occult malignancy and prescribed testosterone enanthate, 200 mg i.m. every 2 weeks. He reported resolution of his anxiety symptoms after 1 month. His concentration and libido increased, and he reported better orgasms. He tried to decrease the frequency of his injections but remained on the bimonthly schedule after feeling his anxiety symptoms returning. He has been on the regimen for more than 18 months and has experienced no side effects. This treatment plan may be continued indefinitely.
    Contraindications to androgen replacement therapy include androgen-dependent cancers, such as prostate and male breast cancer, and benign prostatic hypertrophy when obstructive symptoms are present <FONT color=#004586>(1)</FONT>. A patient’s hematocrit and low-density/high-density lipoprotein ratio should be monitored, since testosterone can elevate these as well <FONT color=#004586>(1)</FONT>.
    The literature supports a connection between hypogonadism and depression, as evidenced by untreated hypogonadal men scoring significantly higher in ratings of depression, anger, fatigue, and confusion than infertile and normal comparison men <FONT color=#004586>(2)</FONT> and by the improvement of depressive symptoms after the administration of testosterone to hypogonadal men with depression refractory to selective serotonin reuptake inhibitors <FONT color=#004586>(3)</FONT>. Another study <FONT color=#004586>(4)</FONT> has shown that testosterone replacement therapy decreases anger, nervousness, and irritability in hypogonadal men. The temporal connection between the improvement of Mr. A’s anxiety symptoms and replacement testosterone suggests an association between anxiety and hypogonadism. With this case report, we suggest including anxiety in the list of psychiatric manifestations of hypogonadism that improve with testosterone replacement therapy.
    <FONT size=+1><STRONG>References</STRONG></FONT>

    <OL compact><A name=R15711BCFDCCGH><!-- null --></A>
    <LI value=1>Wang C, Swerdloff R: Androgen replacement therapy. Ann Med 1997; 29:365–370<!-- HIGHWIRE ID="157:11:1884:1" --><FONT color=#004586>[Medline]</FONT><!-- /HIGHWIRE --> <A name=R15711BCFHCEEJ><!-- null --></A>
    <LI value=2>Burris A, Banks S, Carter S, Davidson J, Sherins R: A long-term, prospective study of the physiologic and behavioral effects of hormone replacement in untreated hypogonadal men. J Androl 1992; 13:297–304<!-- HIGHWIRE ID="157:11:1884:2" --><NOBR><FONT color=#004586>[Abstract/</FONT><FONT color=#cc0000>Free</FONT><FONT color=#004586>&nbsp;Full&nbsp;Text]</FONT></NOBR><!-- /HIGHWIRE --> <A name=R15711BCFFCHHA><!-- null --></A>
    <LI value=3>Seidman SN, Rabkin JG: Testosterone replacement therapy for hypogonadal men with SSRI-refractory depression. J Affect Disord 1998; 48:157–161<!-- HIGHWIRE ID="157:11:1884:3" --><FONT color=#004586>[CrossRef]</FONT><FONT color=#004586>[Medline]</FONT><!-- /HIGHWIRE --> <A name=R15711BCFHICDE><!-- null --></A>
    <LI value=4>Wang C, Alexander G, Berman N, Salshian B, Davidson T, McDonald V, Steiner B, Hull L, Callegari C, Swerdloff RS: Testosterone replacement therapy improves mood in hypogonadal men: a clinical research center study. J Clin Endocrinol Metab 1996; 81:3578–3583<!-- HIGHWIRE ID="157:11:1884:4" --><FONT color=#004586>[Abstract]</FONT><!-- /HIGHWIRE --> </LI>[/list]
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    Joined: April 1st, 2004, 4:56 pm

    September 3rd, 2007, 12:34 pm #5


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    http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=9543205&dopt=AbstractPlus

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    Testosterone replacement therapy for hypogonadal men with SSRI-refractory depression.

    <P class=affiliation>Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA.

    <P class=abstract>BACKGROUND: Testosterone replacement therapy is an effective treatment of some depressive symptoms in hypogonadal men, and may be an effective augmentation treatment for SSRI-refractory major depression in such men. METHODS: We treated five depressed men who had low testosterone levels and had not responded to an adequate SSRI trial with 400 mg testosterone replacement biweekly for 8 weeks. Four patients underwent single-blind placebo discontinuation. Patients were assessed at baseline and biweekly thereafter using the Hamilton Depression Rating Scale (HAM-D) and the Endicott Quality of Life Enjoyment and Satisfaction Scale (Q-LES-Q). RESULTS: Patients' mean age was 40 years, and mean testosterone level 277 ng/dl. All had a rapid and dramatic recovery from major depression following testosterone augmentation: mean 21-item HAM-D decreased from 19.2 to 7.2 by week 2, and to 4.0 by week 8; mean Q-LES-Q increased from 45% to 68%. Three of four subjects who underwent discontinuation of testosterone under single-blind placebo treatment began to relapse. CONCLUSION: Testosterone replacement therapy may be an effective treatment of depressive symptoms in some men, and warrants further research.

    <P class=pmid>PMID: 9543205 [PubMed - indexed for MEDLINE]
    Last edited by Ch_Isp_Morse on September 3rd, 2007, 12:38 pm, edited 1 time in total.
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    Joined: April 1st, 2004, 4:56 pm

    September 3rd, 2007, 12:38 pm #6

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    Joined: April 1st, 2004, 4:56 pm

    September 3rd, 2007, 1:38 pm #7

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    © 2003 <FONT color=#004586>American Psychiatric Association</FONT> </FONT>

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    Testosterone Gel Supplementation for Men With Refractory Depression: A Randomized, Placebo-Controlled Trial <STRONG>Harrison G. Pope, Jr., M.D., Geoffrey H. Cohane, B.A., Gen Kanayama, M.D., Ph.D., Arthur J. Siegel, M.D. and James I. Hudson, M.D., Sc.D. </STRONG>
    <!-- ABS -->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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