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Impact of exogenous testosterone on mood: A systematic review and meta-analysis of randomized placebo-controlled trials

Hamid R. Amanatkar, MD

Department of Neurology and Psychiatry, Saint Louis University, St. Louis, Missouri, USA

John T. Chibnall, PhD

Department of Neurology and Psychiatry, Saint Louis University, St. Louis, Missouri, USA

Byung-Woun Seo, PhD

Global Medical Affairs, AbbVie, North Chicago, Illinois, USA

Jothika N. Manepalli, MD

Department of Neurology and Psychiatry, Saint Louis University, St. Louis, Missouri, USA

George T. Grossberg, MD

Department of Neurology and Psychiatry, Saint Louis University, St. Louis, Missouri, USA

Background: In the last decade, there has been a surge of new clinical trials studying the impact of exogenous testosterone on mood. The results of these studies have been inconsistent.

Methods: Meta-analysis of controlled clinical trials using common depression rating scales was performed.

Results: Sixteen trials with a total of 944 subjects met selection criteria. Meta-analysis of data showed a significant positive impact of testosterone on mood (z=4.592; P < .0001). Subgroup analysis showed a significant effect size of 5.279 (P < .0001) in the trials with a mean age of <60 years. However, the effect size was not statistically significant in those trials with a mean age of >60 years. The effect size in hypogonadal men was 4.192 (P < .0001), whereas the result was not statistically significant in eugonadal men. In addition, the effect size was larger in subthreshold depression compared with major depression. Oral testosterone compared with oral dehydroepiandrosterone, testosterone gel, and intramuscular testosterone did not show a significant result. Larger effect size was observed in the studies of 8 to 24 weeks’ duration.

Conclusions: Testosterone may be used as a monotherapy in dysthymia and minor depression or as an augmentation therapy in major depression in middle-aged hypogonadal men.

Keywords: meta-analysis, subthreshold depression, major depression, hypogonadism, testosterone, dehydroepiandrosterone

ANNALS OF CLINICAL PSYCHIATRY 2014;26(1):19-32

CORRESPONDENCE: Hamid Reza Amanatkar, MD Department of Neurology and Psychiatry 1438 South Grand Blvd St. Louis, MO 63104 USA E-MAIL: amanatkarhr@slu.edu
Annals of Clinical Psychiatry ©2014 Quadrant HealthCom Inc.

 
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