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


CONCLUSIONS
Testosterone replacement therapy may be an effective treatment of depressive symptoms in some men, and warrants further research.
Seidman
S N
SN
Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA.
Rabkin
J G
JG
D000328:Adult; D003863:Depression / Q000150:complications / Q000188:drug therapy*; D004351:Drug Resistance; D006801:Humans; D007006:Hypogonadism / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D016037:Single-Blind Method; D013739:Testosterone / Q000172:deficiency* / Q000627:therapeutic use*; D016896:Treatment Outcome
D017367:Selective Serotonin Reuptake Inhibitors; D013739:Testosterone