Feb. 17, 2005 CHICAGO – The over-the-counter hormonal therapy known as DHEA may be an effective treatment of midlife-onset minor and major depression, according to a study in the February issue of The Archives of General Psychiatry, one of the JAMA/Archives journals. DHEA (dehydroepiandrosterone), an adrenal androgen and neurosteroid is available as a supplement in the U.S.
Complementary and alternative medicine is a multimillion dollar industry, reflecting a growing number of people who avoid traditional medication, including anti-depressants, according to information provided in the article. Alternative therapies may have potential as second- or third-line treatments but controlled evaluations of these potential therapeutic agents are needed, the study's authors suggested. DHEA has been previously reported to have antidepressant-like effects. The current study was designed to evaluate DHEA as a treatment for depression with a midlife onset.
Peter J. Schmidt, M.D., from the Behavioral Endocrinology Branch of the National Institute of Mental Health, Rockville, Md. and colleagues, evaluated 23 men and 23 women aged 45 to 65 with midlife onset major or minor depression of moderate severity. They were randomly assigned to either receive six weeks of DHEA therapy, three weeks each of two dosages, or six weeks of placebo treatment. Following the six weeks of DHEA therapy and a period of one or two weeks without any therapy, the treatment groups were reversed. The participants in the study were evaluated at three and six weeks during the treatment phases with standard measures of depression and a sexual functioning scale.
A 50 percent or greater reduction in the baseline of their score on a depression rating scale was observed in 23 patients after DHEA and in 13 patients after placebo. Six weeks of DHEA treatment was associated with significant improvements in measures of depression and sexual functioning compared to both baseline and six weeks of placebo treatment, the researchers found.
In conclusion the authors write, "At present, there are no predictors of response, and with a 50 percent response rate one would obviously select more reliable first-line treatments for this condition. However, in the 50 percent of depressed outpatients who do not respond to first-line antidepressant treatment, 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."
(Arch Gen Psychiatry. 2005;62:154-162. Available post-embargo at archgenpsychiatry.com)
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