Dehydroepiandrosterone treatment of midlife dysthymia

Background: This study evaluated the efficacy of the adrenal androgen, dehy droepiandrosterone, in the treatment of midlife-onset dysthymia. Methods: A double-blind, randomized crossover treatment study was performed as follows: 3 weeks on 90 mg dehydroepiandrosterone, 3 weeks on 450 mg deh ydroepiandrosterone, and 6 weeks on placebo. Outcome measures consisted of the following. Cross-sectional self-ratings included the Beck Depression In ventory, and visual analogue symptom scales. Cross-sectional objective rati ngs included the Hamilton Depression Rating Scale, the Cornell Dysthymia Sc ale and a cognitive test battery. Seventeen men and women aged 45 to 63 yea rs with midlife-onset dysthymia participated in this study. Response to deh ydroepiandrosterone or placebo was defined as a 50% reduction from baseline in either the Hamilton Depression Rating Scale or the Beck Depression Inve ntory. Results: In 15 patients who completed the study, a robust effect of dehydro epiandrosterone on mood was observed compared with placebo. Sixty percent o f the patients responded to dehydroepiandrosterone at the end of the 6-week treatment period compared with 20% on placebo. A significant response was seen after 3 weeks of treatment on 90 mg per day, The symptoms that improve d most significantly were anhedonia, loss of energy, lack of motivation, em otional "numbness," sadness, inability to cope, and worry. Dehydroepiandros terone showed no specific effects on cognitive function or sleep disturbanc e, although a type II error could not be ruled out. Conclusions: This pilot study suggests that dehydroepiandrosterone is an ef fective treatment for midlife-onset dysthymia.