DHEA and depression

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.

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Source: American Journal of Psychiatry. 2006 Jan;163(1):59-66.

Placebo-controlled trial of dehydroepiandrosterone (DHEA) for treatment of nonmajor depression in patients with HIV/AIDS

Authors: Rabkin JG, McElhiney MC, Rabkin R, McGrath PJ, Ferrando SJ.
New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, New York

OBJECTIVE: Subsyndromal major depressive disorder is common among HIV-positive adults. This study was designed to assess the efficacy of dehydroepiandrosterone (DHEA) as a potential treatment. METHOD: One hundred forty-five patients with subsyndromal depression or dysthymia were randomly assigned to receive either DHEA or placebo; 90% (69 of 77) of the DHEA patients and 94% (64 of 68) of the placebo patients completed the 8-week trial. The primary measure of efficacy was a Clinical Global Impression improvement rating of 1 or 2 (much or very much improved) plus a final Hamilton Depression Rating Scale score <or=8. Outcome was assessed by using intent-to-treat analysis, followed by completer analysis. Safety was assessed by queries about side effects at every study visit plus measures of CD4 cell count and HIV RNA viral load at baseline and week 8. DHEA dosing was flexible (100-400 mg/day). RESULTS: On the basis of clinicians’ ratings, DHEA was superior in the intent-to-treat analysis, where the response rate was 56% (43 of 77) for the DHEA group versus 31% (21 of 68) for the placebo group. In the completer analysis, the response rate was 62% (43 of 69) for the DHEA group, compared to 33% (21 of 64) for the placebo patients. The number needed to treat was 4 on the basis of intent-to-treat data and 3.4 on the basis of completer data. Few adverse events were reported in either treatment group, and no significant changes in CD4 cell count or HIV RNA viral load were observed in either group.

CONCLUSIONS: Nonmajor but persistent depression is common in patients with HIV/AIDS, and DHEA appears to be a useful treatment that is superior to placebo in reducing depressive symptoms. The low attrition rate in this group of physically ill patients, together with requests for extended open-label treatment, reflect high acceptance of this readily available intervention.

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3 thoughts on “DHEA and depression

  1. Not to disparage the use of pharmaceuticals, as there is defintely an appropriate use of medication for the treatment of depression. However, depression is often best treated through traditional psychotherapy – so that you get to the root of your issue instead of putting a band-aid on it. Most people don’t go to therapy because it is inconvenient and they feel stigmatized by going in person. The answer is to get therapy online. http://www.mytherapynet.com offers the largest selection of licensed therapists in the world. You can communicate by instant messaging, telephone, or computer-based audio and video conferencing. Getting an early intervention for depression dramatically shortens treatment time (you can expect to feel better in cases in just a few sessions) and you will find that you are back to work quicker and not having a prolonged negative impact on your friends and family.

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