The effect of the weak androgen oxandrolone on psychological and behavioral characteristics in growth hormone-treated girls with Turner syndrome.
The weak androgen oxandrolone (Ox) increases height gain in growth-hormone (GH) treated girls with Turner syndrome (TS), but may also give rise to virilizing side effects. To assess the effect of Ox, at a conventional and low dosage, on behavior, aggression, romantic and sexual interest, mood, and gender role in GH-treated girls with TS, a randomized, placebo-controlled, double-blind study was conducted. 133 patients were treated with GH (1.33 mg/m(2)/d) from baseline, combined with placebo (Pl), Ox 0.03 mg/kg/d, or Ox 0.06 mg/kg/d from the age of eight, and with estrogens from the age of 12. The child behavior checklist (CBCL), Junior Dutch Personality Questionnaire (DPQ-J), State-subscale of the Spielberger's State-Trait Anger Scale, Romantic and Sexual Interest Questionnaire, Mood Questionnaire, and Gender Role Questionnaire were filled out before, during, and after discontinuing Ox/Pl. The changes during Ox/Pl therapy were not significantly different between the dosage groups. In untreated patients, the mean CBCL total (P=0.002) and internalizing (P=0.003) T scores, as well as the mean DPQ-J social inadequacy SD score (SDS) (P=0.004) were higher than in reference girls, but decreased during GH+Ox/Pl therapy (P<0.001, P=0.05, P<0.001, respectively). Whereas the mean total (P=0.01) and internalizing (P<0.001) T score remained relatively high, the mean social inadequacy SDS became comparable with reference values. We conclude that in GH-treated girls with TS, Ox 0.03 mg/kg/d or 0.06 mg/kg/d does not cause evident psychological virilizing side effects. Problem behavior, frequently present in untreated girls with TS, decreases during therapy, but total and internalizing problem behavior remain increased.
Menke
Leonie A
LA
Leiden University Medical Center, Department of Pediatrics, Leiden, the Netherlands. l.a.menke@lumc.nl
Sas
Theo C J
TC
Visser
Martje
M
Kreukels
Baudewijntje P C
BP
Stijnen
Theo
T
Zandwijken
Gladys R J
GR
de Muinck Keizer-Schrama
Sabine M P F
SM
Otten
Barto J
BJ
Wit
Jan M
JM
Cohen-Kettenis
Peggy T
PT
D000293:Adolescent; D000339:Affect / Q000187:drug effects; D000374:Aggression / Q000187:drug effects; D000728:Androgens / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004644:Emotions / Q000187:drug effects; D004967:Estrogens / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005783:Gender Identity; D019382:Human Growth Hormone / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D001523:Mental Disorders / Q000188:drug therapy; D010074:Oxandrolone / Q000008:administration & dosage / Q000627:therapeutic use*; D019529:Sexuality / Q000187:drug effects; D016896:Treatment Outcome; D014424:Turner Syndrome / Q000188:drug therapy* / Q000523:psychology*
D000728:Androgens; D004967:Estrogens; D019382:Human Growth Hormone; D010074:Oxandrolone