TREATMENT OF DEPRESSION IN HIV- LITERATURE-REVIEW AND REPORT OF AN ONGOING STUDY OF TESTOSTERONE REPLACEMENT THERAPY( MEN )

Our research program was designed to assess androgenic, anabolic, and mood effects of testosterone replacement therapy in human immunodefici ency virus positive (HIV+) men with significant immune suppression and hypogonadism. This article focuses on mood effects. Treatment consist ed of biweekly intramuscular injections of testosterone cypionate at d oses of 200 to 400 mg. Assessments included psychiatric evaluation usi ng the Structured Clinical Interview for DSM-III-R, Hamilton Rating Sc ale for Depression, and Brief Symptom Inventory. This is an interim re port of 73 men who completed at least eight weeks of treatment. Respon ders continued for four more weeks and then entered a double-blind pla cebo controlled discontinuation phase. At study entry, 49% had CD4 cou nts under 50, and 84% had an acquired immune deficiency syndrome (AIDS )-defining condition. In terms of sexual desire and function, 76% were clearcut responders at Week 8. Of the 31 study completers who had moo d problems at baseline, 26 (84%) were rated as much improved in mood. Mean changes in CD4 cell count and beta 2 microglobulin after treatmen t were no: statistically significant. These findings suggest that test osterone replacement therapy has significant antidepressant effects fo r men with significant immunodeficiency and clinical manifestations of hypogonadism.