title: [Role of prasterone (dehydroepiandrosterone) in substitution therapy for adrenocortical insufficiency].
abstract: Prasterone (dehydroepiandrosterone; DHEA) is a steroid hormone from the adrenal cortex with weak androgenic properties. It can be converted into stronger acting steroids with both androgenic and oestrogenic properties. DHEA also appears to have an affinity with certain receptors in the brain and can act as a neurosteroid. Patients with primary or secondary adrenocortical insufficiency exhibit a marked decrease in DHEA production and the added value of DHEA replacement in these patients has been investigated in three recently published trials. With a daily dose of 50 mg DHEA, the plasma levels of DHEAS (the sulphate of DHEA) increase to levels within the normal range and beneficial effects have been demonstrated for several psychological parameters such as mood, fatigue, general well-being and sexual function. The androgenic side effects on skin and hair appear to be both moderate and acceptable. For patients with adrenocortical insufficiency who function suboptimally despite adequate replacement therapy with glucocorticosteroids and (if indicated) mineralocorticosteroids, these results would seem to justify treatment with a replacement dose of DHEA.
authors.affiliation: Afd. Interne Geneeskunde, onderafd. Endocrinologie, Universitair Medisch Centrum, Postbus 85.500, 3508 GA Utrecht. p.m.j.zelissen@digd.azu.nl
authors.forename: P M
authors.initials: PM
authors.lastname: Zelissen
authors.forename: J H
authors.initials: JH
authors.lastname: Thijssen
mesh_terms: D000309:Adrenal Insufficiency / Q000188:drug therapy*; D019314:Dehydroepiandrosterone Sulfate / Q000627:therapeutic use*; D020249:Hormone Replacement Therapy / Q000379:methods*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D019314:Dehydroepiandrosterone Sulfate