High-Dose Testosterone & Depression

We wanted to share an interesting article on Testosterone and Depression. It is always a hot topic and one for debate.

“Testosterone treatment, especially at higher dosages, may reduce depressive symptoms in men, new research suggests.

Investigators analyzed 27 randomized controlled trials (RCTs) that included almost 1900 men and found that those patients who were treated with testosterone were more than twice as likely to experience a reduction in depressive symptoms compared to their counterparts who received placebo.

The effect was particularly pronounced at higher doses.

These findings remained even when variables such as age, depressive burden, and gonadal status were taken into account. The only two relevant variables were dosage and symptom variability.

“The main findings are that testosterone significantly reduces depressive symptoms compared to placebo, and with testosterone, men are 2.3 times more likely to show clinically relevant symptom reduction compared to placebo,” lead author Andreas Walther, PhD, professor of biological psychiatry, Technische Universität Dresden, Germany, told Medscape Medical News.

Moreover, “although many possible influencing variables were investigated, the dosage and symptom variability were the only moderators identified — that is, when higher dosage regimens were administered and the men within the studies showed similar depressive burden in which all were very depressed or had only a low depressive burden, the effects were greater,” he said.

The study was published online November 14 in JAMA Psychiatry.

Protective Effect?
“Testosterone is a neuroactive hormone that influences numerous behavioral patterns, such as libido or aggression,” said Walther.

“However, it is believed that testosterone also has a positive effect on neuroplasticity and thus protects the brain through increased neuronal survival, making it more adaptable and better able to cope with depressive symptoms.

“It has long been discussed whether low testosterone levels in men are associated with increased depressive symptoms,” Walther noted, but “this association has only been observed in some subgroups of men, such as dysthymic or treatment-resistant depressive men,” he added.

Nevertheless, “there have been several studies that have attempted to apply testosterone to improve mood, but the results were very mixed [so we] wanted to compile all these findings to identify the true effect of testosterone in depressive symptoms in men.”

To investigate the question, the researchers analyzed 27 RCTs (n = 1890 men), chosen via a stepwise process of elimination from 7690 identified records.”


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