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In brief: DHEA for depression

In brief

DHEA for depression

DHEA (dehydroepiandrosterone) is best known as a “natural” substance taken by some major-league ballplayers. It’s a hormone secreted by the adrenal glands and converted by the body to male and female hormones. Although not, strictly speaking, a dietary ingredient, it’s widely available on grocery and pharmacy shelves as a nutritional supplement.

Production of DHEA in the body peaks around age 20 in both sexes and quickly declines until, by age 70, most of us are making hardly any. So the supplements have been promoted as an anti-aging panacea. DHEA has been credited with the capacity to resist infection, bulk up muscles, produce weight gain or weight loss, prevent cancer and heart disease, improve sexual performance, and change the way the body metabolizes and stores fat. The National Institute on Aging rejects these commercial claims.

DHEA does seem to lift mood, at least temporarily, in many people, and the treatment of mood disorders is one of its more plausible potential uses. In studies on more lasting mood change, the results have been inconsistent, but research sponsored by the National Institute of Mental Health suggests that DHEA can relieve depression in middle-aged people.

The subjects were 46 patients age 40–65 with major depression or minor depression (symptoms similar to major depression but lasting for a shorter time). All received DHEA for six weeks and a placebo for six weeks, taking a low dose of 90 mg a day for three weeks and a high dose of 450 mg a day for three weeks.

While taking DHEA, 23 patients responded — showed a 50% decrease on a standard rating scale for symptoms of depression. Only 13 responded while taking the placebo. After the first six weeks of treatment, 8 of 14 patients receiving DHEA were still depressed, compared with 14 of 15 receiving the placebo. Ten patients who improved on DHEA chose to continue taking it at a low dose (25–50 mg per day) and remained free of depression for up to a year.

The response did not depend on age, the severity of the symptoms, or a person’s original level of sex hormones (testosterone and estrogen). Men and women responded equally. Blood levels of free (active) testosterone increased a little (17%) in men and greatly (500%) in women; blood levels of DHEA also increased in both sexes. But these changes were not correlated with improvement, so the treatment was not correcting a simple DHEA deficiency. Just how it works is unclear.

In this study there were no serious side effects. Common short-term side effects of DHEA are headache, nasal congestion, fatigue, acne, and oily skin. The long-term effects are uncertain — there may be a potential for masculinizing effects on women, breast development in men, cardiovascular damage, and prostate cancer.

The authors conclude that short-term treatment with DHEA might be useful for some patients with mild to moderate depression who do not respond to standard treatments or cannot tolerate antidepressant drugs. The effects of the hormone in more severe depression and in the long run are unknown. And it’s worth mentioning once again that unregulated dietary supplements come with no guarantee of purity or safety.

Schmidt PJ, et al. “Dehydroepiandrosterone Monotherapy in Midlife-Onset Major and Minor Depression,” Archives of General Psychiatry (February 2005): Vol. 62, No. 2, pp. 154–62.

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Last updated:	August 21, 2006