Testosterone Treatment of Depressive Disorders in Men Too Much Smoke, Not Enough High-Quality Evidence

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In summary, this meta-analysis suggests that among non-depressed hypogonadal men, testosterone replacement may enhance mood. Overall, some epidemiologic evidence and a limited amount of clinical trials’ evidence suggests that a late-life–onset DD may be associated with late-onset hypogonadism; randomized trials of the efficacy of testosterone replacement as a specific antidepressant therapy in such men are warranted. A large placebo-controlled, randomized, doubleblind, multicenter study of topical testosterone replacement therapy in 6000 symptomatic hypogonadal men at increased risk for cardiovascular disease is currently being conducted in the United States (the TRAVERSE trial). One substudy of the TRAVERSE trial will determine the efficacy of testosterone replacement therapy in inducing remission of depression in middle-aged and older hypogonadal men with late-onset DD. Until then, the clinicians should follow the Endocrine Society guideline for testosterone replacement therapy of androgen-deficient men ; the available data do not support the use of testosterone treatment, especially in supraphysiologic doses, for the treatment of depressive disorders in men.


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