DHEA May Help Midlife Depression
Posted 08 February 2005 - 02:49 PM
Conventional Antidepressants Still the First Line of Defense, Says Study
By Miranda Hitti
WebMD Medical News Reviewed By Brunilda Nazario, MD
on Monday, February 07, 2005
Feb. 7, 2005 -- The hormonal supplement DHEA could help relieve mild to moderate depression that starts in middle age, new research shows.
Still, DHEA probably isn't the first option patients should consider, say the researchers. In their small study, treatment with DHEA resulted in a 50% reduction in depression symptoms in half the participants.
"With a 50% response rate, one would obviously select more reliable first-line treatments for this condition," write the researchers, who included Peter J. Schmidt, MD, of the National Institute of Mental Health (NIMH).
"However," the researchers write, "in the 50% of depressed outpatients who do not respond to first-line antidepressant treatments, or in those unwilling to take traditional antidepressants, DHEA may have a useful role in the treatment of mild to moderately severe midlife-onset major and minor depression."
Their findings appear in the February edition of the Archives of General Psychiatry.
Depression is Widespread
Every year, about 9% of the U.S. adult population -- nearly 19 million people -- have depression, says the NIMH. Women are affected twice as often as men, but depression can strike either sex at any age.
Depression can be devastating, grinding life to a crawl. It can make ordinary tasks seem overwhelming and robs patients of pleasures they once enjoyed. Depression also casts a long shadow over physical health, as mind and body are intertwined.
Depression is also highly treatable. Counseling, medication, and lifestyle changes can help tremendously. But for many people, the hardest part is reaching out for help. If patients only ask, doctors and therapists can often help find solutions to revive wellbeing.
A growing number of people are exploring alternatives to conventional antidepressants, say the researchers. Since DHEA has been reported to help soothe depression, Schmidt's team tested it against midlife depression.
DHEA is a naturally occurring steroid hormone that is a precursor to the male sex hormone testosterone and the female sex hormone estrogen.
Made by the adrenal glands, DHEA production dwindles starting in early adulthood. By age 70, DHEA production is about 20% of that in the late teens or early 20s.
DHEA supplements are widely available over the counter and on the Internet. Its popularity has been fueled by claims of antiaging effects, which has also attracted the interest of researchers.
But since the FDA doesn't regulate supplements, it's hard to know exactly what's being sold. That alarms some health experts, especially since people often take supplements without telling their doctors.
The study was small and brief. It included 23 men and 23 women age 40 to 65 with mild to moderate depression starting in midlife. None was severely depressed or taking other antidepressants. Besides their depression, they were in good health.
Subjects were assigned to take either DHEA or a placebo for six weeks. After a 1-2 week break, the groups switched to the other pill for six more weeks.
Two DHEA doses were used. For three weeks, patients took a lower dose -- 90 milligrams per day. For the other three weeks, they took 450 milligrams of DHEA daily.
Less Depression with DHEA
In 23 participants, DHEA cut depression symptoms by 50% or more. A similar reduction was seen in 13 subjects after taking the placebo. Men and women responded similarly.
Treatment with the supplement was associated with an increase in testosterone blood levels in both men and women.
Taking DHEA for 6 weeks also significantly improved sexual function scores, compared to the scores after taking the placebo or before the study started.
DHEA was well tolerated. Acne and oily skin were the most common adverse effects.
Because of the study's design, its findings don't apply to severely depressed patients, say the researchers. They also warn that DHEA's long-term effects aren't known and that more studies are needed.
SOURCES: Schmidt, P., Archives of General Psychiatry, Feb. 2005; vol 62: pp 154-162. WebMD Medical News: "Hormone Protects Against Diseases of Aging." News release, JAMA/Archives. National Institute of Mental Health, "Depression."
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