New York Buyers’ Club - The Blog

Andrew Weill reports on studies suggesting that Rosavin, made from Rhodiola rosea, may be helpful in sustaining mood.

http://www.drweil.com/drw/u/WBL02081/Herb-Reduces-Depression-May-Extend-Life.html

Rhodiola rosea is not a widely known botanical remedy, but perhaps it should be. Several recent studies have revealed that the herbal extract of this yellow-flowered, Arctic mountain plant may have multiple health benefits. A study published in the Nordic Journal of Psychiatry, reporting on people with mild-to-moderate depression, showed that patients who took a Rhodiola extract known as SHR-5 (sold under the trade name Arctic Root) reported fewer symptoms than those who took a placebo. And a study by researchers at the University of California at Irvine revealed that fruit flies that ate a diet rich with Rhodiola lived an average of 10 percent longer than those that ate three other herbs known for their life-extension properties.

As usual, these modern findings come long after indigenous people have already determined the plant’s value. Russians and Scandinavians have used it for centuries to combat stress and depression.

See also NYBC entry on Rosavin, a Rhodiola rosea extract produced by Ameriden.

As human beings, we face these types of deep hurts in the course of a life. Facing our own death or the death of a loved one is profound.

One woman’s experience is reflected in this video. She is a neuroscientist, driven to study the brain in part from the experience of living with a relative with schizophrenia. It is about 18 minutes long–and VERY much worth it.

http://www.microclesia.com/?p=320

Learning to live with these agonies is as much the art of living. How do we respond to challenges? Do we judge ourselves to harshly when things don’t work out the way we would like? Can we find a less judgmental, more open space in which to accept both the joys and struggles of life? Can we learn to forgive others and ourselves for harms inflicted? In the buddhist tradition, meditation is thought of as a practice. And living day-to-day, moment-to-moment as challenges arise represents the opportunity to navigate the way we respond to and engage with life with increasing skill and openness.

Another remarkable individual is Stephen Levine. He has written a number of books, including the seminal work, Who Dies, published originally in 1982. His wisdom is deep and he provides great guidance without judgment. One meditation from that book that illustrates some of his viewpoints is below. Check it out–and by all means, get a copy of the book! It is skillful and compassionate.

Self Forgiveness Meditation

Reflect for a moment on that quality we call forgiveness. Bring into your mind, actually into your heart, the image of someone for whom you have much resentment. Take a moment to feel that person right there at the centre of your chest in the heart centre.

And in your heart say to that person, ‘I forgive you for anything you may have done in the past, either intentionally or unintentionally, through your thoughts, words or actions that caused me pain. I forgive you’.

Slowly allow that person to settle into you heart.

Don’t judge yourself for how difficult it is.

No force, just opening slowly to them at your own pace.

Say to them, ‘I forgive you. I forgive you for the pain you caused me in the past, intentionally or unintentionally, through your thoughts, your deeds, your words. I forgive you’.

Gently, gently open to them. If it hurts, let it hurt. Gradually open to that person. That resentment, that incredible anger, even if it burns, ever so gently though. Forgiveness.

‘I forgive you’.

Let your heart open to them.

It is so painful to hold someone out of your heart.

‘I forgive you’.

Let your heart open just a bit more to them. Just a moment of opening, of forgiveness, letting go of resentment.

Allow them to be forgiven.

Now opening more to forgiveness, bring into your heart the image of someone from whom you wish to ask forgiveness.

Speak to them in your heart. ‘I ask your forgiveness for anything I may have done in the past that caused you pain, either by my thoughts or my actions or my words. Even for those things I didn’t intend to cause you pain, I ask for your forgiveness’.

‘For all those words that were said out of forgetfulness or fear. Out of my closedness, out of my confusion. I ask for forgiveness’.

Don’t allow any resentment you hold for yourself to block your reception of that forgiveness. Let your heart soften to it. Allow yourself to be forgiven.

Let yourself be freed.

Let that unworthiness come up, that anger at yourself – let it all fall away.

Let it all go.

Open to the possibility of forgiveness.

‘I ask your forgiveness for whatever I may have done in the past that caused you pain. By the way I acted or spoke or thought, I ask your forgiveness’.

It is so painful to hold yourself out of your heart. Bring yourself into your heart. Say ‘ I forgive you’, to yourself. Don’t reject yourself.

Using your own first name, in your heart say, ‘I forgive you’. Open to that. Let it be. Make room in your heart for yourself.

‘I forgive you’.

All those resentments, let them fall away.

Open to the self-forgiveness. Let yourself have some space.

Let go of that bitterness, that hardness, that judgement of yourself.

Say ‘I forgive you’ to you.

Let some glimmering of loving kindness be directed toward yourself. Allow your heart to open to you. Let that light, that care for yourself, grow.

Self-forgiveness.

Watch how thoughts of unworthiness and fears of being self indulgent try to block the possibility of once and for all letting go of that hardening.

See the freedom in self-forgiveness. How can you hold that pain even a moment longer?

Feel that place of love and enter into it. Allow yourself the compassion, the care, of self-forgiveness. Let yourself float gently in the open heart of understanding, of forgiveness, and peace.

Feel how hard it is for us to love ourselves. Feel the pain on the hearts of all those caught in confusion. Forgive them, forgive yourself, let go gently of the pain that hides the immensity of your love.

We’ve spoken recently about the study of HIV and aging produced by ACRIA, a non-profit, community-based AIDS medical research and treatment education organization.

A main finding of the 2006 study is the prevalence of depression among older adults with HIV. In its survey of about 1000 older HIV+ adults, ACRIA researchers found that they experienced depression at a rate almost 13 times as higher than the general population. And for people with HIV, the consequences of depression are associated with many physical issues, far beyond just “feeling down”:

“By suppressing the immune system, depression may render people more vulnerable to infectious diseases. Stress and depression have harmful effects on cellular immunity, including those aspects of the immune system affected by HIV. Body cell mass depletion is associated with significant increases in fatigue, global distress and depressive symptomatology, and reduced life satisfaction. Elevated symptoms of depression are associated with a faster progression to AIDS and a higher risk of mortality. Depressive symptoms, especially in the presence of severe stress, are related to decreases in CD4 cell count and declines in several lymphocytes.”

These study findings and other related research motivated NYBC to assemble up-to-date information on dietary supplements and depression. See, for an overview, this information sheet:

Printable version of the info sheet, including a chart for quick comparison of these supplements as used to address depression

More information on the individual supplements is also available on the NYBC website, at  www.newyorkbuyersclub.org, as well as on this Blog, under “Depression.”

Here’s more on the role of the B Vitamins in depression, together with some common supplementation strategies.

Source: University of Maryland Medical Center’s Complementary Medicine web resource

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DepressionStudies suggest that vitamin B9 (folate) may be associated with depression more than any other nutrient. Between 15% and 38% of people with depression have low folate levels in their bodies and those with very low levels tend to be the most depressed. Many healthcare providers start by recommending a multivitamin (MVI) that contains folate, and then monitoring the homocysteine levels in the blood to ensure the adequacy of therapy. Elevated homocysteine levels indicate a deficiency of folate even if the levels of folate in the blood are normal. If the MVI alone is not enough to lower homocysteine and improve folate function, the provider may suggest additional folate along with vitamins B6 and B12 to try to bring the homocysteine levels down, thereby eliminating the functional folate deficiency and, hopefully, helping to improve feelings of depression.

Note: NYBC stocks Douglas Lab’s Added Protection Without Iron, a highly bioavailable multivitamin that includes a comprehensive B complex. The no-iron formula is recommended especially if you have elevated liver enzymes or hepatitis.

You can also consider Added Protection With Iron if you want to include iron in your supplements.

Another choice for focusing on the B Vitamins is Jarrow’s B-right, which is especially formulated to provide optimal amounts of folate/folic acid (B-9), B-6 and B-12 for lowering homocysteine levels.

This FAQ is now posted on the New York Buyers’ Club website in an easy-to-navigate format:

FAQ ON NUTRITIONAL SUPPLEMENTS

Topics covered include supplements used to improve gut function, manage cholesterol/triglycerides, address liver disease, help with mood/memory, maintain lean muscle mass and optimal weight, and address conditions like nausea, diarrhea and neuropathy.

Although we’ve given a lot of attention to supplements that have been studied specifically for depression, such as SAM-e, DHEA, St. John’s Wort, Tryptophan, and 5-HTP, this note from the University of Maryland Medical Center’s Complementary Medicine website reminded us of the importance of looking at general nutritional status in assessing and responding to complex health conditions like depression. In this case, it’s a suggestion that supplementing with B Vitamins can have an impact on depressive symptoms.

See additional information in NYBC’s entry on its B Vitamin supplement.
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Depression
Studies suggest that vitamin B9 (folate) may be associated with depression more than any other nutrient. Between 15% and 38% of people with depression have low folate levels in their bodies and those with very low levels tend to be the most depressed. Low folate levels tend to lead to elevated homocysteine levels. Many healthcare providers recommend a B complex multivitamin that contains folate as well as vitamins B6 and B12 to improve symptoms. If the multivitamin with these B vitamins is not enough to bring elevated homocysteine levels down, the physician may then recommend higher amounts of folate along with vitamins B6 and B12. Again, these three nutrients work closely together to bring down high homocysteine levels, which may be related to the development of depression.

We’ve reported on the NIH-funded trial of antidepressants SAM-e (a dietary supplement) and Lexapro (a prescription drug) currently underway at Massachusetts General Hospital and Butler Hospital (see under “SAM-e” on this Blog).

Recently one of our NYBC associates drew our attention to an interview from a few years back with Richard Brown, M.D., clinical psychiatry professor at Columbia University with a long-time interest in depression treatments. Dr. Brown has had experience using SAM-e to treat depression in people with HIV, and notes that the added benefits of this dietary supplement for joint and liver health may make it a very good option for treatment over the longer term.

See also the NYBC entry on SAM-e.

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Used in tandem with conventional antidepressants, SAM-e also enhances their effectiveness. A study published in Psychiatry Research comparing 40 depression sufferers taking imipramine, half of whom were also given 400 mg of SAM-e a day, found a significant difference between the two treatments. “The SAM-e group was much better in four days,” says Brown. And compared with other pharmaceutical antidepressants, SAM-e also has fewer nasty side effects.

With so much going for it, Brown believes there’s no reason not to use SAM-e. “Eighty percent of people with depression have to be on medication for a lot of their adult lives,” says Brown. “I’d rather give them something that does good things in their bodies as they get older.”
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Citation: Psychology Today Magazine, Mar/Apr 2001 - Last Reviewed 14 Dec 2006

This post runs a little long, but we think it’s worthwhile to put up the FAQ about nutritional supplements recently posted by the New York Buyers’ Club. It answers a lot of (sometimes anxious) queries about supplements, and also gives a quick rundown on some of the top uses of supplements among the NYBC membership.

What are supplements?
A nutritional or dietary supplement (or just plain supplement), as defined by the Dietary Supplement Health and Education Act (DSHEA) of 1994, is “a product (other than tobacco) that is intended to supplement the diet and that contains one or more of the following: vitamins, minerals, herbs or other botanicals, amino acids, or any combination of the above ingredients,” and can be taken in tablet, capsule, powder, or liquid form.
NYBC specializes in supplements for those with HIV, hepatitis C, and other chronic conditions. Our Supplement Fact Sheets contain information on more than 100 supplements commonly used by our Members. Our nonprofit purchasing co-op stocks these supplements on a regular basis, and can also special-order many other supplements on request.
Why take supplements?
There is a great deal of research showing that supplements can help people manage serious chronic conditions such as HIV and hepatitis. Supplements can also be useful in addressing many common health issues, such as high cholesterol, diabetes, depression, arthritis pain, gastrointestinal disorders, etc. (see our short list of specifics below). Some supplements are derived from ancient traditions of use (for example, the botanicals of India’s Ayurvedic tradition), while other items (such as vitamins or amino acids) have been isolated and used as supplements much more recently. The scientific study of supplements has blossomed in recent decades, so we now have better evidence about many of them—even traditional botanicals—than we ever did in the past.
Are supplements considered “medicine”?
While supplements may have medicinal properties, they are not regulated in the same way that prescription drugs are, and are therefore accompanied by the disclaimer: “These statements have not been evaluated by the Food & Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.”
The fact that supplements are not regulated in the same way that prescription drugs are naturally gives rise to concerns about purity, efficacy, and safety – so it’s good to have a knowledgeable ally like NYBC on your side! Collectively, we have many years of experience in using supplements, in researching information on them, and in evaluating suppliers to obtain the best quality product.
Are supplements “safe”?
Under current US regulations, supplements are assumed to be safe on the basis of their history of use, or because they are found in the food supply (like the microorganisms in yogurt or the vitamins and minerals in foods). The US Food and Drug Administration is responsible for removing supplements from the market if it finds evidence that they are unsafe, but it’s worth noting that this happens quite rarely. (The removal from the market of ephedra [aka the Chinese herb Ma huang], used at high dosage as a diet pill, is practically the only significant example since 1994). However, while supplements may be “assumed to be safe,” everyone who takes them needs to pay attention to the recommended dosage and any cautions or warnings. If you exceed the recommended dosage of certain supplements, there may be side effects, sometimes serious. Furthermore, a supplement may have negative interactions with other medications you are taking, or a particular supplement may not be a wise choice for you due to other health concerns. That’s why it’s always important to discuss your supplement use with your doctor.

Here are just a few examples of potentially dangerous supplement-medication interactions (from the National Center for Complementary and Alternative Medicine’s website) - further proof that consulting your physician about supplement use is crucial:

• St. John’s Wort can increase the effects of prescription drugs used to treat depression. It also dangerously interferes with drugs used for HIV, cancer, birth control, and rejection of organ transplants

• Ginseng can increase the stimulant effects of caffeine (as in coffee, tea, and cola). It can also lower blood sugar levels, creating the possibility of problems when used with diabetes drugs

• Ginkgo, taken with anticoagulant or antiplatelet drugs, may increase the risk of bleeding. Ginkgo may also interact with certain psychiatric drugs and with certain drugs that affect blood sugar levels

Of course, doing your own “homework” is also encouraged. Be sure to bring any notes or printouts from your research to share with your healthcare provider. That way, you’ll both be literally on the same page.
Identity, Purity and Potency
Safety is also a matter of product quality. Is the product what it claims to be on the label (that is, is it really fish oil)? This is the product Identity. Does the product contain any unwanted contaminants like heavy metals, insect parts, rodent droppings? All foods and medicinal products face these issues of Purity. And finally, does it have as much of the claimed amount of a substance? For example, if it says 100 mg of niacin, does it have that amount? This is the product’s Potency. These issues are of ongoing concern. NYBC has done everything possible to assure that products meet these standards. Websites such as www.consumerlab.com can help. Also indications of quality such as USP or other labels further add assurance. The good news is that the vast majority of products tested by consumerlab, for example, pass their tests. Still, NYBC believes an appropriately funded agency of the FDA could do more rigorous, routine and comprehensive testing.
What is CAM?
CAM is an acronym for complementary and alternative medicine. The use of supplements is considered CAM. Some prefer the term integrative medicine.
The National Center for Complementary and Alternative Medicine (NCCAM), a division of the US National Institutes of Health, defines CAM as “a group of diverse medical and health care systems, practices and products that are not presently considered to be part of conventional medicine.” NCCAM, like the US Office of Dietary Supplements, came into being after passage of DSHEA, and marks the federal government’s decision to commit funding to research and education about CAM. Over a billion dollars in your tax dollars have been spent by these agencies since their start.

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Using Supplements
What supplements can I use to improve my immune system?
Agents such as a potent multivitamin, NAC (N-acetyl cysteine), alpha lipoic acid and whey can all help offset oxidative stress and nutrient losses caused by HIV as well as the free radical generation and inflammation-related damage that some antiretroviral drugs cause.
For those with HIV, supplementation can be a valuable assist in restoring the body’s immune system, as evidenced by many studies, such as Dr. Jon Kaiser’s HIV Micronutrient Study, which showed a significant increase (26%) in the CD4 counts of the subjects who maintained a supplement regimen in addition to their regular medications. FYI: NYBC offers a “MAC Pack” (Micronutrient - Antioxidant Combination Pack), a product very similar to the one used in the study.
What supplements can be used to improve gut function?
Acidophilus or bifidus, glutamine, whey proteins, Saccharomyces boulardii (Florastor) and a good multi can all be important to offset gastrointestinal problems, whether HIV-related or of other origin.
What supplements can I use to manage my blood fats (cholesterol and triglyceride levels)?
“Bad cholesterol” (LDL) and triglycerides can be reduced with agents such as carnitine, pantethine, and fish oils. Niacin may be an excellent option which can also help increase HDL (“good cholesterol”). For heart health in general, aside from diet and exercise, CoEnzyme Q10 may also be of help (may also be useful in countering statin-related side effects).
What supplements are used to improve mental function and/or mood?
Acetylcarnitine, 5-HTP, tyrosine, ginkgo biloba, fish oils, SAM-e, DHEA, theanine, or St. John’s Wort may help mental function and alleviate depression, though each of these must be taken with some care (and not all together!)
See also: a full dossier on Memory Loss and Other Brain Problems from our Health+HIV section of Recommended Reading on the website www.newyorkbuyersclub.org; also recommended is the NYBC info sheet on Depression and supplements on this blog, under “Depression.”
What supplements can I use to combat fatigue?
Various conditions can cause fatigue, but in general, B12 (methylcobalamin) and Eleuthero (used to be “Siberian ginseng” - don’t use with high blood pressure!) may all help to improve energy. A good start may also be as simple as a good multivitamin!
For more information about the causes and treatments for fatigue, see our Fatigue Fact Sheet on the NYBC website.
What supplements can I use to stabilize my weight?
For those experiencing weight loss, whey proteins, carnitine and creatine plus CLA may all help - but of course especially in conjunction with a good diet and routine exercise! And we agree with Dr. Jon Kaiser and many others: resistance exercise remains an important component of a successful HIV management plan.
What supplements are used to treat nausea?
NYBC recommends ginger; marijuana, while effective, is not carried by the NYBC, as it is not yet approved for medical use in New York. For detailed information about the causes and treatments for nausea, see Health+HIV section of Recommended Reading on the NYBC website.
What supplements are used to improve liver function?

Liver function can be impaired due to several reasons, including disease, alcohol abuse, and the effects of some cholesterol-lowering drugs (statins).
While making sure there aren’t any interactions with your meds, supplements like milk thistle (Silymarin), NAC, alpha lipoic acid, Hepato-C or Hepato-Detox, Hepatoplex I or II, Ecliptex, SAM-e and Clear Heat are options to consider (again, not all at once!)
What supplements can be used to treat diarrhea?
NYBC suggests supplementing your diet with glutamine and calcium. For more information about the causes and other possible treatments, see our Fact Sheet about diarrhea in Recommended Reading, at www.newyorkbuyersclub.org.
What supplements can combat neuropathy?
Much scientific evidence now points to acetylcarnitine as an effective approach to countering neuropathy (numbness, tingling, or pain, usually in the extremities, which can be caused by HIV, diabetes or by some medications).

The New York Times - January 17, 2008
Antidepressant Studies Unpublished
By BENEDICT CAREY
The makers of antidepressants like Prozac and Paxil never published the results of about a third of the drug trials that they conducted to win government approval, misleading doctors and consumers about the drugs’ true effectiveness, a new analysis has found.
In published trials, about 60 percent of people taking the drugs report significant relief from depression, compared with roughly 40 percent of those on placebo pills. But when the less positive, unpublished trials are included, the advantage shrinks: the drugs outperform placebos, but by a modest margin, concludes the new report, which appears Thursday in The New England Journal of Medicine.

….

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Pharmaceutical companies mislead the public about the effectiveness of their prescription antidepressants.

That’s the bottom line of this New York Times story, which reports on an investigation published in the New England Journal of Medicine this week.
Well, not surprising. We knew that the FDA drug approval process, which ideally should represent a gold standard in evaluating the effectiveness and safety of medicines, has been seriously compromised by its dependence on pharmaceutical company-funded research.
And, we think we know why there’s comparatively little public attention given to some very substantial research showing that such dietary supplements as DHEA, SAM-e, St. Johns Wort may be useful for depression. These are supplements, not patentable drugs, so the pharmaceutical companies can’t establish exclusive rights to them and charge enormous sums for their distribution.
If you’d like to take a look at some of the evidence about dietary supplements for depression, look under the “Depression” category of this blog, or refer to the information sheet on depression from the New York Buyers’ Club.

Elsewhere on this blog, we’ve reported on a new NIH-funded trial of SAM-e for depression being conducted at Massachusetts General and Butler Hospitals. One of the aims of the study is to compare SAM-e to the prescription anti-depressant Lexapro.
We also want to call attention to earlier research that focused specifically on SAM-e as a anti-depressant for people with HIV, who have been shown to have higher rates of depression than the general population. This research was organized by the AIDS Community Research Initiative of America, which has long been a leader in promoting new and significant studies that respond to the needs of people with HIV/AIDS.
The ACRIA study was published in the peer-reviewed journal, BMC Psychiatry (www.biomedcentral.com/bmcpsychiatry) in 2004. The results of this pilot study were promising and, as the organization stated in its Winter 2004/2005 news bulletin, offered findings of particular interest to people with HIV, who may find it easier to add a dietary supplement to their regimens rather than “yet another drug with potential side effects.”
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More on this dietary supplement on the NYBC website:

SAM-e

This was the title of a New York Times article by Jane Gross published on January 6, 2008.  Focusing on several case studies, the piece highlighted “a constellation of ailments showing up prematurely or in disproportionate numbers among the first wave of AIDS survivors to reach late middle age.”

There’s no doubt that the article is timely: the number of people 50 and older living with HIV has increased 77 percent from 2001 to 2005, according to the federal Centers for Disease Control, and they now are a quarter of all cases in the United States (about 116,000). And, it’s certainly true, as the piece suggests, “the graying of the AIDS epidemic has increased interest in the connection between AIDS and cardiovascular disease, certain cancers, diabetes, osteoporosis, and depression.”

The New York Buyers’ Club (like its predecessor DAAIR) has always been engaged in looking ahead in order to size up and respond to the special health issues faced by people with HIV, whether those issues derive from the virus itself, or from medication side-effects. So if you’d like to know more about how our membership has used dietary supplements over the longer haul to maintain and improve their health, and to counter symptoms and medication side-effects, please do continue to consult this blog, as well as our website, found at www.newyorkbuyersclub.org. Also–if you’d like to be included the mailing and/or email list for our quarterly publication THE SUPPLEMENT, just drop a line to contact@newyorkbuyersclub.org. NYBC doesn’t claim to have all the answers to the health concerns of people with HIV, but you might be surprised at how many useful recommendations and suggestions (based on much reviewing of the science and many years of accumulated experience) our nonprofit information exchange has to offer.

Here are citations for two well-designed recent studies on DHEA and depression. The first was undertaken by the NIH/National Institute of Mental Health and used DHEA as the sole therapy with a group of men and women aged 45 to 65 who were experiencing major or minor midlife-onset depression. The researchers concluded that DHEA was an effective treatment for this group. Note: a further item of interest is that DHEA therapy was also found to be associated with improvement in sexual function. (Contrast with certain prescription anti-depressants, which shall remain nameless!)
The second study, by Judith Rabkin et al. at Columbia Univ., focused on people with HIV and examined DHEA as a therapy for non-major depression, especially among a group that was not in the best physical health. The finding: DHEA was an effective and useful therapy under these conditions.
For more information on DHEA, including recommendations for use, see the NYBC
description of

DHEA - Douglas Laboratories

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Source: Arch Gen Psychiatry. 2005 Feb;62(2):154-62.

Dehydroepiandrosterone monotherapy in midlife-onset major and minor depression.

Authors: Schmidt PJ, Daly RC, Bloch M, Smith MJ, Danaceau MA, St Clair LS, Murphy JH, Haq N, Rubinow DR. Behavioral Endocrinology Branch, National Institute of Mental Health, Rockville, MD 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.S ettings 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.