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No. 4 (2023)

ORIRGINAL RESEARCH

Therapy of Depression in Men with Testosterone Deficiency: A Comparative Study of Pharmacological Treatment

https://doi.org/10.21265/PSYPH.2023.87.86.003

Published 2023-12-30

  • Yu.Yu. Osadshiy
    • ,
  • K. Vasilchenko
    • ,
  • V.A. Soldatkin

Yu.Yu. Osadshiy
Rostov State Medical University

K. Vasilchenko
Bar-Ilan University

V.A. Soldatkin
Rostov State Medical University

Abstract

Background. The treatment of depression in men with testosterone deficiency presents specific challenges due to the overlap of symptoms of both depression and hormone deficiency. The treatment choice for these cases still lacks consensus in the scientific community. There is a clear need for further research and a comprehensive approach to develop more effective diagnostic and treatment methods for this complex issue.
Objective. To compare the effectiveness of treatment approaches for depression in men with testosterone deficiency: thymoanaleptic therapy, hormonal correction, and complex therapy, including a combination of an antidepressant and testosterone preparation.
Material and methods. The study included 140 male participants aged from 18 to 65 years who were diagnosed with recurrent depressive disorder (F33) and single depressive episode (F32) according to ICD-10, along with testosterone deficiency (< 12.1 nmol/L). Participants from the main group (n = 90) were randomly allocated to three therapeutic subgroups of 30 individuals each: those receiving sertraline monotherapy, testosterone monotherapy, and combined therapy with sertraline and testosterone. The control group consisted of men with depression and normal testosterone levels (n = 50) who received only sertraline. The average age of participants in the main group was 50.58 ± 8.43 years, and 41.16 ± 10.35 years in the control group. The differences between groups were statistically significant (p < 0.001).
Results. Initial depression levels were comparable between therapeutic groups (p > 0.05) but were higher in the control group (p < 0.001). Combined therapy outperformed testosterone from the third visit (p = 0.002) and was comparable to sertraline. Side effects included: nausea in the sertraline group (42.11 %), increased blood pressure in the testosterone group (44.44 %), and nausea and headache in the combined group (40 %). In the control group, nausea was the most common side effect (25.64 %).
Conclusion. Combined therapy for depression in men with testosterone deficiency using sertraline and testosterone supplement did not show advantages over antidepressant monotherapy.

Keywords

depression, testosterone, men, testosterone deficiency, treatment

PDF (Русский)

References

  1. Abbafati C., Abbas K.M., Abbasi-Kangevari M. et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: A systematic analysis for the Global Burden of Disease Study 2019 // Lancet. – 2020. – Vol. 396 (10258). – Pp. 1204–1222. – https://doi.org/10.1016/S0140-6736(20)30925-9
  2. Александровский Ю.А. Социогенные психические расстройства // Российский психиатрический журнал. – 2014. – № 3. С. 19–23. – http://dx.doi.org/10.24411/1560-957X-2014-1%25x
  3. Мосолов С.Н. Проблемы психического здоровья в условиях пандемии COVID-19. // Журнал неврологии и психиатрии имени С.С. Корсакова. – 2020. – № 5 (120). – C. 156–164. – https://doi.org/10.17116/jnevro20201200517
  4. Мосолов С.Н. Длительные психические нарушения после перенесенной острой коронавирусной инфекции SARS-CoV-2 // Современная терапия психических расстройств. – 2021. – № 3. – С. 2–23. – https://doi.org/10.21265/PSYPH.2021.31.25.001
  5. Salk R.H., Hyde J.S., Abramson L.Y. Gender differences in depression in representative national samples: Meta-analyses of diagnoses and symptoms // Psychological Bulletin. – 2017. – Vol. 143 (8). – Pp. 783–822. – https://doi.org/10.1037/bul0000102
  6. Labaka A., Goñi-Balentziaga O., Lebeña A., Pérez-Tejada J. Biological sex differences in depression: A systematic review // Biological Research For Nursing. – 2018. – Vol. 20 (4). – Pp. 383–392. – https://doi.org/10.1177/1099800418776082
  7. Kuehner C. Why is depression more common among women than among men? // Lancet Psychiatry. – 2017. – Vol. 4 (2). – Pp. 146–158. – https://doi.org/10.1016/S2215-0366(16)30263-2
  8. Hauger R.L., Saelzler U.G., Pagadala M.S., Panizzon M.S. The role of testosterone, the androgen receptor, and hypothalamic-pituitary-gonadal axis in depression in ageing men // Reviews in Endocrine and Metabolic Disorders. – 2022. – Vol. 23 (6). – Pp. 1259–1273. – https://doi.org/10.1007/s11154-022-09767-0
  9. Zitzmann M. Testosterone, mood, behaviour and quality of life // Andrology. – 2020. – Vol. 8 (6). – Pp. 1598–1605. – https://doi.org/10.1111/andr.12867
  10. Васильева О.В. Селятицкая В.Г. Связь ожирения с уровнем тестостерона, признаками тревоги, депрессии и ускоренного старения у мужчин // Сибирский научный медицинский журнал. – 2018. – Т. 38, № 1. – С. 81–86.
  11. Осадший Ю.Ю., Солдаткин В.А., Крючкова М.Н., Фаустова А.Г. Депрессия у мужчин с дефицитом тестостерона // Журнал неврологии и психиатрии имени С.С. Корсакова. – 2021. – Т. 121 (10). – С. 19–24. – https://doi.org/10.17116/jnevro202112110119
  12. Brydges S., Rennick-Egglestone S., Anderson C. Men’s views of antidepressant treatment for depression, and their implications for community pharmacy practice // Research in Social and Administrative Pharmacy. – 2020. – Vol. 16 (8). – Pp. 1041–1049. – https://doi.org/10.1016/j.sapharm.2019.10.016
  13. Määttänen I., Gluschkoff K., Komulainen K., Airaksinen J., Savelieva K., García-Vela´zquez R., Jokela M. Testosterone and specific symptoms of depression: Evidence from NHANES 2011–2016 // Comprehensive Psychoneuroendocrinology. – 2021. – Vol. 6. – Art. 100044. – https://doi.org/10.1016/j.cpnec.2021.100044
  14. Amini S., Jafarirad S., Abiri B. Vitamin D, testosterone and depression in middle-aged and elderly men: a systematic review // Critical Reviews in Food Science and Nutrition. – 2023. – Vol. 63 (21). – Pp. 5194–5205. – https://doi.org/10.1080/10408398.2021.2015284
  15. Васильченко К.Ф., Усова А.А., Жданова Ю.А. и др. Взаимосвязь критических способностей и самостигматизации у пациентов с параноидной шизофренией // Сибирский вестник психиатрии и наркологии. – 2020. – № 1 (106). – С. 23–30. – https://doi.org/10.26617/1810-3111-2020-1(106)-23-30
  16. Snyder P.J., Bhasin S., Cunningham G.R. et al. Lessons From the Testosterone Trials // Endocrine Reviews. – 2018. – Vol. 39 (3). – Pp. 369–386. – https://doi.org/10.1210/er.2017-00234
  17. Anderson D.J., Vazirnia P., Loehr C. et al. Testosterone replacement therapy in the treatment of depression // Health Psychology Research. – 2022. – Vol. 10 (4). – Art. 38956. – https://doi.org/10.52965/001c.38956
  18. Walther A., Breidenstein J., Miller R. Association of Testosterone treatment with alleviation of depressive symptoms in men: A systematic review and meta-analysis // JAMA Psychiatry. – 2019. – Vol. 76 (1). – Pp. 31–40. – https://doi.org/10.1001/jamapsychiatry.2018.2734
  19. Dwyer J.B., Aftab A., Radhakrishnan R. et al. Hormonal treatments for major depressive disorder: state of the art // American Journal of Psychiatry. – 2020. – Vol. 177 (8). – Pp. 686–705. – https://doi.org/10.1176/appi.ajp.2020.19080848
  20. Bhasin S., Seidman S. Testosterone treatment of depressive disorders in men: Too much smoke, not enough high-quality evidence // JAMA Psychiatry. – 2019. – Vol. 76 (1). – Pp. 9–10. – https://doi.org/10.1001/jamapsychiatry.2018.2661
  21. Pavlidi P., Kokras N., Dalla C. Antidepressants’ effects on testosterone and estrogens: What do we know? // European Journal of Pharmacology. – 2021. – Vol. 899. – Art. 173998. – https://doi.org/10.1016/j.ejphar.2021.173998
  22. Malhi G.S., Bassett D., Boyce P. et al. Royal Australian and New Zealand College of psychiatrists clinical practice guidelines for mood disorders // Australian & New Zealand Journal of Psychiatry. – 2015. – Vol. 49. – Pp. 1087–206. – https://doi.org/10.1177/0004867415617657
  23. Hamilton M. A rating scale for depression // Journal of Neurology, Neurosurgery and Psychiatry. – 1960. – Vol. 1 (23). – Pp. 56–62.
  24. Zierau F., Bille A., Rutz W., Bech P. The gotland male depression scale: A validity study in patients with alcohol use disorder // Nordic Journal of Psychiatry. – 2002. – Vol. 4 (56). – Pp. 265–271. – https://doi.org/10.1080/08039480260242750
  25. Sigurdsson B., Palsson S.P., Aevarsson O. et al. Validity of gotland male depression scale for male depression in a community study: the Sudurnesjamenn study // Journal of Affective Disorders. – 2015. – Vol. 1 (173). – Pp. 81–89. – https://doi.org/10.1016/j.jad.2014.10.065
  26. Автономов Д.А. Мужской депрессивный синдром // Независимость личности. – 2014. – № 2. – С. 8–11.
  27. Food and Drug Administration. Approval letter. – Application Number 19-839/S-44, 20-990/S-010. – 2003. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2003/019839_S044_ZOLOFT%20TABLETS%20&%20ORAL%20CONCENTRATE_APPROV.pdf (accessed September 12, 2023).
  28. Gautam S., Jain A., Gautam M., Vahia V.N., Grover S. Clinical practice guidelines for the management of depression // Indian Journal of Psychiatry. – 2017. – Vol. 59, suppl. 1. – Pp. S34–S50. – https://doi.org/10.4103/0019-5545.196973
  29. Cipriani A., La Ferla T., Furukawa T.A., et al. Sertraline versus other antidepressive agents for depression // The Cochrane Database of Systematic Reviews. – 2010. – Vol. (4). – Art. CD006117. – https://doi.org/10.1002/14651858.CD006117.pub4
  30. Lochmann D., Richardson T. Selective serotonin reuptake inhibitor // Handbook of Experimental Pharmacology. – 2019. – Vol. 250. – Pp. 135–144. – https://doi.org/10.1007/164_2018_172
  31. McKinney W. et al. Data structures for statistical computing in python // Proceedings of the 9th Python in Science Conference. – 2010. – Vol. 445. – Pp. 51–56.
  32. Virtanen P., Gommers R., Oliphant T.E., et al. SciPy 1.0: Fundamental algorithms for scientific computing in python // Nature Methods. – 2020. – Vol. 17. – Pp. 261–272. – https://doi.org/10.1038/s41592-019-0686-2
  33. Van Rossum G., Drake F.L. Python 3 reference manual. – Scotts Valley, CA: CreateSpace, 2010.
  34. Amiaz R., Pope H.G. Jr., Mahne T., Kelly J.F., Brennan B.P., Kanayama G., Weiser M., Hudson J.I., Seidman S.N. Testosterone gel replacement improves sexual function in depressed men taking serotonergic antidepressants: A randomized, placebo-controlled clinical trial // Journal of Sex & Marital Therapy. – 2011. – Vol. 37 (4). – Pp. 243–254. – https://doi.org/10.1080/0092623X.2011.582425
  35. Van Rooij K., Poels S., Worst P., Bloemers J., Koppeschaar H., Goldstein A., Olivier B., Tuiten A. Efficacy of testosterone combined with a PDE5 inhibitor and testosterone combined with a serotonin (1A) receptor agonist in women with SSRI-induced sexual dysfunction. A preliminary study // European Journal of Pharmacology. – 2014. – Vol. 753. – Pp. 246–251. – https://doi.org/10.1016/j.ejphar.2014.10.061
  36. Мосолов С.Н. Современные биологические гипотезы рекуррентной депрессии (обзор) // Журнал неврологии и психиатрии имени С.С. Корсакова. – 2012. – Т. 112, № 11-2. – С. 29–40.
  37. Kirsch I. Placebo effect in the treatment of depression and anxiety // Frontiers in Psychiatry. – 2019. – Vol. 10. – Art. 407. –https://doi.org/10.3389/fpsyt.2019.00407
  38. Lewis G., Duffy L., Ades A. et al. The clinical effectiveness of sertraline in primary care and the role of depression severity and duration (PANDA): A pragmatic, double-blind, placebocontrolled randomized trial // Lancet Psychiatry. – 2019. – Vol. 6 (11). – Pp. 903–914. – https://doi.org/10.1016/S2215-0366(19)30366-9
  39. Anagha K., Shihabudheen P., Uvais N.A. Side effect profiles of selective serotonin reuptake inhibitors: A cross-sectional study in a naturalistic setting // Primary Care Companion for CNS Disorders. – 2021. – Vol. 23 (4). – Art. 20m02747. –https://doi.org/10.4088/PCC.20m02747
  40. Федеральное руководство по использованию лекарственных средств (формулярная система). – Вып. IV / под ред. А.Г. Чучалина. – М.: Эхо, 2003.
  41. Федеральное руководство по использованию лекарственных средств (формулярная система) – 10-е изд. / под ред. А. Г. Чучалина, Ю. Б. Белоусова, В. В. Яснецова. – М.: Эхо, 2009.
  42. Snyder P.J., Bhasin S., Cunningham G.R. et al. Testosterone trials investigators. Effects of testosterone treatment in older men // The New England Journal of Medicine. – 2016. – Vol. 374 (7). – Pp. 611–624. – https://doi.org/10.1056/NEJMoa1506119

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