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Intramuscular Testosterone Supplementation Ameliorates Depression in Hypogonadal Men: A Retrospective Study in an Outpatient Department

Miclea A, Miclea M, Pistor M, Stegmayer K, Hoepner R

Pharmacopsychiatry, 2018

Abstract

INTRODUCTION: Substantial evidence has indicated an association between hypogonadism and depressive symptoms, which led to the conduction of studies that found an ameliorating effect of testosterone (T) supplementation (S) upon depression in men.

METHODS: Retrospective analysis of medical records identified 16 depressed, hypogonadal men who have not responded adequately to initial antidepressant therapy and subsequently received intramuscular T injections. Following the proposal of Button et al., a minimal clinically important difference was defined as an 18% reduction of the Beck Depression Inventory-II (BDI-II) score.

RESULTS: After TS, the BDI-II score decreased by approximately 31% (p<0.01), from 27.2 (mean; standard deviation [SD] 11.8) to 18.8 (mean; SD 11.3). Patients with baseline BDI-II scores ranging from 29 to 63 (severe depression) showed a significantly higher absolute and relative reduction through TS. Also, men with a shorter depression duration (<2 years) demonstrated a greater benefit.

CONCLUSIONS: The depressed, hypogonadal men generally benefited from TS given that the BDI-II score reduction was almost twice as much as needed for a minimal clinically important difference.

How strong is the evidence?

Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.

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