Here what i have bring to my doc. before he give me androgel:
1:Clinical & Research News
Testosterone May Boost Efficacy Of Antidepressants in Men
Joan Arehart-Treichel
Testosterone gel may produce antidepressant effects in men who are not responding to conventional medication.
When middle-aged men are depressed and antidepressants dont help them, there may be another effective treatment for themtestosterone.
Indeed, this is what Harrison Pope Jr., M.D., chief of the Biological Psychiatry Lab at McLean Hospital in Belmont, Mass., and coworkers found in a small, preliminary study. They reported their results in the January American Journal of Psychiatry.
"These preliminary findings," they wrote, "suggest that testosterone gel may produce antidepressant effects in the large and probably underrecognized population of depressed men with low testosterone levels."
Past studies have shown that some depressed men have low blood levels of testosterone. Men with underdeveloped testes often show depressive symptoms, and testosterone replacement may improve these symptoms. This tantalizing evidence, combined with the fairly recent availability of testosterone supplementation via a transdermal gel, prompted Pope and his coworkers to undertake an exploratory study. They wanted to see whether a testosterone gel might counter depression in men who hadnt gotten relief from antidepressants and who had testosterone levels on the low side for their age.
First Pope and his colleagues attempted to recruit, via radio ads and clinical referrals, potential subjects for their study. They were interested in men between 30 and 65 years of age who were experiencing a major depression and who were not receiving any relief from antidepressants. Fifty-six men expressed interest in participating in the investigation. Pope and his coworkers then tested each of the 56 men for morning blood levels of testosterone; 24 (43 percent) had borderline or low levels for their age (350 ng/dl or less).
Twenty-two of these men were then entered into the study, and they continued to take the same antidepressants that they had taken before. But in addition, 12 were randomized to receive 10 gms of a 1 percent testosterone gel daily for eight weeks, and the remaining 10 were randomized to receive a placebo gel daily for eight weeks. The researchers then tracked the subjects depression during the eight-week treatment period, using the Hamilton Depression Rating Scale, the Clinical Global Impression severity of illness scale, and the Beck Depression Inventory.
The subjects getting the testosterone gel improved, on average, significantly more than the subjects on a placebo, according to the Hamilton Depression Rating Scale. The improvement was evident on both the psychological aspects of depression, such as depressed mood, anxiety, or guilt, and on the somatic aspects of depression, such as sleep, appetite, and libido. The subjects getting the gel also showed, on average, a significantly greater rate of decrease in scores on the Clinical Global Impression severity of illness scale, but not on the Beck Depression Inventory.
Thus, it looks as if a testosterone gel might be able to help some depressed middle-aged men who receive no relief from antidepressants and who also have low levels of testosterone, Pope and his team concluded.
They also suspect that "low testosterone levels may be unexpectedly common in middle-aged men with treatment-resistant depressive disorder" since almost half of the 56 men who had been interested in participating in their study had borderline or low testosterone levels.
As far as negative side effects were concerned, one subject on testosterone reported difficulty urinating, suggesting that the testosterone was possibly exacerbating a case of benign prostatic hyperplasia. None of the other 11 subjects getting testosterone, however, reported any adverse effects. Thus, short-term treatment with testosterone gel appeared to produce minimally unfavorable effects.
This preliminary study, of course, did not answer some crucial questions, the researchers noted. For instance, what effect would testosterone supplementation over a longer period have on depression? Would it help depressed men not taking antidepressants, or would it be more useful as an adjunct to antidepressant treatment? Would giving testosterone over the long haul aggravate benign prostate hyperplasia or increase the risk of prostate cancer? And finally, how might testosterone counter depression? "It is too early to speculate," Pope told Psychiatric News, "because it is a very idiosyncratic response in that some of our subjects responded dramatically, whereas others had absolutely no effect."
Given the positive results from this preliminary study, however, and the potential public health benefits that might accrue from them, the value of testosterone as a depression treatment should definitely be explored, Pope and his team believe.
The study report, "Testosterone Gel Supplementation for Men With Refractory Depression: A Randomized, Placebo-Controlled Trial," is posted on the Web at http://ajp.psychiatryonline.org/cgi/content/full/160/1/105.
2-TESTOSTERONE RELIEF FOR SOME MALE DEPRESSION
Gabe Mirkin, M.D.
Recent research from Harvard Medial School shows that rubbing testosterone gel on the skin can help relieve depression in middle-aged men with low blood testosterone levels. In the 1940s, experiments showed that major depression can be relieved by injecting testosterone into men with low levels. The treatment never caught on because effective antidepressant drugs started coming to market. More recently, however, testosterone patches and gels became available. In June 2000, the United States Food and Drug Administration approved a new form of gel for treating muscle loss, decreased sex drive, lack of energy, and other symptoms of so-called hypogonadism, or underactivity of the testes.
Harrison Pope, A professor of psychiatry are Harvard Medical School wondered if the gel might also help males with the combination of low testosterone and depression not treated successfully with drugs. He received a grant from Unimed Pharmaceuticals Corp., which makes a topical skin testosterone gel called AndroGel. Of the first 56 men screened, Pope and his colleagues found 24 who were both depressed and had low levels of that hormone. More than 40 percent of the men who applied to be admitted to the study suffered from both low testosterone and depression.
Twelve men rubbed 2.5 grams of AndroGel on their skins each night. Another 10 subjects received identical packets containing a placebo. By the end of the experiment, Pope found a significant improvement in mood among those taking testosterone compared with those using the dummy rub. Ten men on the active gel completed the full eight-week study. Three showed almost no improvement, and four experienced only modest relief. However, three enjoyed "striking, dramatic gains."
In any given year, eight percent of American men over 30 years old will experience an episode of major depression. Only a few of these men will get significant help from popular antidepressants. "If this refractory subgroup exhibits a 43 percent prevalence of low testosterone levels, as found in our study," notes Pope's report, "then hundreds of thousands of men in a given year might be candidates for further trials of the teststerone supplements. Normal men who take testosterone usually add muscle and lose fat. That occurred among those in the Harvard study, including subjects whose depression was not reduced. One man, who got no psychiatric benefit at all, gained about 15 pounds of muscle mass and lost about eight pounds of fat. Such results raise the issue of whether the supplements aid only the physical symptoms of depression such as loss of energy, libido, and appetite.
Pope's group found higher moods, less guilt and anxiety, and a decrease of suicidal thoughts. "These analyses suggest that the hormone can cause improvements in both the mind and body," Pope says. Evidence also exists that some women may be helped by testosterone supplements. Other studies hint that postmenopausal women, and those who have had their ovaries removed surgically, may reap some benefits in terms of improved mood and energy. But to avoid excess growth of hair, increased muscle mass, and other masculine side effects, doses would have to be much lower than those given to men. Although there is little evidence that testosterone causes prostate cancer, it can spread an existing prostate cancer. Men who take testosterone must have their prostates checked and get a blood test that screens for prostate cancer called PSA every three months while on the male hormone.
The Archives of Psychiatry, January, 2003
3-Study Suggests spects of depression (such as depressed mood, guilt and psychological anxiety) and the somatic aspects of depression (such as sleep, appetite and libido). Testosterone replacement gel also was associated with significantly greater rates of decrease in CGI-severity scores. A significant difference was not found on the BDI. Side effects were modest, although one man described increased difficulty in urination and withdrew from the study.
"Our trial, although preliminary, was planned to help guide future studies," said Pope. "More research is needed to carefully assess the long-term benefits and risks of testosterone replacement therapy."
According to data from the National Comorbidity Survey, a seminal U.S. study on the prevalence of mental illness, approximately eight percent of American men over the age of 30 will exhibit major depressive disorder in a given year.1 Antidepressant medication will be partially or completely ineffective for many of these men.
Research support provided by Unimed Pharmaceuticals, Inc., a wholly owned, independently operated subsidiary of Solvay Pharmaceuticals, Inc.
Reference:
1) Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, Wittchen HU, Kendler KS. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Arch Gen Psychiatry 1994; 51: 8-19.
