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DHEA Depression Studies - Cached

 
 
Dehydroepiandrosterone Monotherapy in Midlife-Onset Major and Minor Depression

Peter J. Schmidt, MD; Robert C. Daly, MD; Miki Bloch, MD; Mark J. Smith, MD, PhD; Merry A. Danaceau, RN; Linda Simpson St. Clair, RN; Jean H. Murphy, RN, MSN; Nazli Haq, MA; David R. Rubinow, MD
 

Arch Gen Psychiatry. 2005;62:154-162.

Context  Alternative and over-the-counter medicines have become increasingly popular choices for many patients who prefer not to take traditional antidepressants. The adrenal androgen and neurosteroid dehydroepiandrosterone (DHEA) is available as over-the-counter hormonal therapy and previously has been reported to have antidepressant-like effects.

Objective  To evaluate the efficacy of DHEA as a monotherapy treatment for midlife-onset depression.

Design  A double-blind, randomized, placebo-controlled, crossover treatment study was performed from January 4, 1996, through August 31, 2002.

Settings  The National Institute of Mental Health Midlife Outpatient Clinic in the National Institutes of Health Clinical Center, Bethesda, Md.

Patients  Men (n = 23) and women (n = 23) aged 45 to 65 years with midlife-onset major or minor depression participated in this study. None of the subjects received concurrent antidepressant medications.

Intervention  Six weeks of DHEA therapy, 90 mg/d for 3 weeks and 450 mg/d for 3 weeks, and 6 weeks of placebo.

Main Outcome Measures  The 17-Item Hamilton Depression Rating Scale and Center for Epidemiologic Studies Depression Scale. Additional measures included the Derogatis Interview for Sexual Functioning. Results were analyzed by means of repeated-measures analysis of variance and post hoc Bonferroni t tests.

Results  Six weeks of DHEA administration was associated with a significant improvement in the 17-Item Hamilton Depression Rating Scale and the Center for Epidemiologic Studies Depression Scale ratings compared with both baseline (P<.01) and 6 weeks of placebo treatment (P<.01). A 50% or greater reduction in baseline Hamilton Depression Rating Scale scores was observed in 23 subjects after DHEA and in 13 subjects after placebo treatments. Six weeks of DHEA treatment also was associated with significant improvements in Derogatis Interview for Sexual Functioning scores relative to baseline and placebo conditions.

Conclusion  We find DHEA to be an effective treatment for midlife-onset major and minor depression.


Author Affiliations: Behavioral Endocrinology Branch, National Institute of Mental Health, Rockville, Md (Drs Schmidt, Daly, Bloch, Smith, and Rubinow, and Mss Simpson St Clair, Murphy, and Haq); and Clinical Center Nursing Department, National Institutes of Health, Department of Health and Human Services, Bethesda, Md (Ms Danaceau).


 
 
Rev Med Brux. 2001 Sep;22(4):A381-6. Related Articles, Links

[DHEA: orthodox or alternative medicine?]

[Article in French]

Cogan E.

Service de Medecine Interne Generale, Hopital Erasme, U.L.B.

The exact physiological role of DHEA remains unknown but DHEA supplementation has recently been proven beneficial in typical deficient states like adrenal insufficiency or major depressive illlnesses. The putative favorable effects of DHEA in other conditions remain controversial. However, recent studies confirmed positive effects of DHEA administration in healthy elderly people, mostly more than 70 years old women, on skin, bone density, muscle strength and several neuropsychological symptoms. Positive effects on sexual interest and satisfaction and sense of well-being are more consistent in elderly women than in men. The recommended administered dose is 25 mg to 50 mg once a day in women and 100 mg in men. Androgenic side effects (greasy skin, acne, increased growth of body hair) are frequent but reversible side effects. Dose adaptation is recommended in these conditions. It is justifiable to prescribe DHEA in patients with adrenal insufficiency. Other possible indications are depression and prolonged glucocorticoid therapy. In elderly people, DHEA administration might be considered in DHEA depleted-patients with skin dryness or atrophy, muscle weakness, low bone density or neuropsychological symptoms. The treatment should be taken under close medical supervision in order to detect a possible hormone-dependent cancer such as breast cancer in women and prostatic cancer in men. The patients should be informed on the potential risks of DHEA administration and on the lack of definitive proven beneficial effects of DHEA, waiting the results of well-conducted controlled double blind prospective studies.
 

 
 
 
Curr Opin Pharmacol. 2003 Dec;3(6):635-41. Related Articles, Links
 
Clinical uses and misuses of dehydroepiandrosterone.

Binello E, Gordon CM.

Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA 02139, USA.

Dehydroepiandrosterone is the most abundant adrenal androgen and also functions as a neurosteroid. Serum concentrations decline with age and can serve as a prognostic factor in both critical illnesses and breast cancer progression. Evidence is accruing in support of dehydroepiandrosterone supplementation in adrenal insufficiency, hypopituitarism, osteoporosis, systemic lupus erythematosus, depression and schizophrenia. Research is ongoing at both the basic and the clinical level to elucidate mechanisms of action and establish efficacy and safety, as well as to expand new areas of potential application for this multi-faceted hormone.

Publication Types:
bulletReview
bulletReview, Tutorial


PMID: 14644016 [PubMed - indexed for MEDLINE]

 
 
 
Am J Psychiatry. 1999 Apr;156(4):646-9. Related Articles, Links
 
Double-blind treatment of major depression with dehydroepiandrosterone.

Wolkowitz OM, Reus VI, Keebler A, Nelson N, Friedland M, Brizendine L, Roberts E.

Department of Psychiatry, University of California Medical Center, San Francisco, USA. owenw@itsa.ucsf.edu

OBJECTIVE: This study was designed to assess possible antidepressant effects of dehydroepiandrosterone (DHEA), an abundant adrenocortical hormone in humans. METHOD: Twenty-two patients with major depression, either medication-free or on stabilized antidepressant regimens, received either DHEA (maximum dose = 90 mg/day) or placebo for 6 weeks in a double-blind manner and were rated at baseline and at the end of the 6 weeks with the Hamilton Depression Rating Scale. Patients previously stabilized with antidepressants had the study medication added to that regimen; others received DHEA or placebo alone. RESULTS: DHEA was associated with a significantly greater decrease in Hamilton depression scale ratings than was placebo. Five of the 11 patients treated with DHEA, compared with none of the 11 given placebo, showed a 50% decrease or greater in depressive symptoms. CONCLUSIONS: These results suggest that DHEA treatment may have significant antidepressant effects in some patients with major depression. Further, larger-scale trials are warranted.

Publication Types:
bulletClinical Trial
bulletRandomized Controlled Trial


PMID: 10200751 [PubMed - indexed for MEDLINE]

 


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