Androgen treatment of depressive symptoms in older men: a systematic review of feasibility and effectiveness.
OBJECTIVE
To determine the feasibility and effectiveness of androgen treatment of depressive symptoms in older men.


METHODS
We searched MEDLINE, PsycINFO, Eric, HealthStar, and the Cochrane Database of Systematic Reviews for potentially relevant articles. The bibliographies of relevant articles were searched for additional references and experts were consulted. Seventeen reports (8 open and 12 randomized trials; 3 articles reported studies of 2 designs) met the following inclusion criteria: original investigation; published in English or French, use of acknowledged criteria or scale for depression, and open or randomized trial of androgen treatment. Four criteria assessed study validity: randomization, double blinding, comparability of treatment and control groups at baseline, and description of dropouts. We abstracted, tabulated, and compared information from each article.


RESULTS
Most studies had methodological limitations. With regard to feasibility, there were few reported withdrawals due to adverse events. With regard to effectiveness, 6 of 8 open trials had positive results, and 5 of 12 randomized trials had positive results, although 1 was equivocal. However, testosterone was combined with antidepressant medication in 3 of these positive randomized trials. Only 2 open trials enrolled subjects whose mean age was 60 years or over. One had positive results, and the other had negative results.


CONCLUSIONS
Androgen therapy may be feasible in the short term, but there is little evidence that it is an effective treatment for depressive symptoms in older men.
Shamlian
Nathalie T
NT
Département de psychiatrie, Service de psychogériatrie, Hôpital du Sacré-Coeur de Montréal, QC. medecins.clinique.memoire.hsc@ssss.gouv.qc.ca
Cole
Martin G
MG
D003687:Dehydroepiandrosterone / Q000627:therapeutic use*; D003863:Depression / Q000188:drug therapy*; D005240:Feasibility Studies; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D013739:Testosterone / Q000627:therapeutic use*; D016896:Treatment Outcome
D013739:Testosterone; D003687:Dehydroepiandrosterone