DHEA May Be Useful In Lifting Depression

http://www.intelihealth.com/IH/ihtIH?t=333&st=333&r=EMIHC000&c=236217

August 10, 1999
The Medical Tribune

The steroid hormone DHEA has been associated with benefits as varied as
boosting the immune system, reversing the aging process, preventing
heart disease and cancer, and building muscle. But it is DHEA's effects
on alleviating depression that may provide the most cause for optimism.

It is known that production of DHEA, or dehydroepiandrosterone, starts
to decline as people reach their late 20s and slumps to about 5 to 10
percent of its peak level by age 80. Some scientists believe this
phenomenon partially explains the greater incidence of depression and
suicide among seniors.

In addition, a number of studies have pointed to the prevalence of low
DHEA in people suffering from post-partum depression, anorexia nervosa
and schizophrenia.

The use of DHEA supplements to self-treat a condition that has been
coined "chronic DHEA deficiency" by the health food stores that sell it
should not be considered until more is known about its safety and
effectiveness, according to a leading psychiatrist who is involved in
ongoing DHEA research.

"We do not know if there are only certain subgroups of patients that
respond to [DHEA]. There are also cases of patients becoming overly
activated, aggressive or psychotic with the treatment," said Dr. Owen
Wolkowitz in an interview. Wolkowitz is professor of psychiatry and
director of the Psychopharmacology Assessment Clinic at the University
of California at San Francisco (UCSF). Such cases, though, are probably
rare, he noted, and similar adverse reactions have also been associated
with prescription antidepressants.

A study conducted by Wolkowitz and co-principal investigator Dr. Victor
Reus, also of UCSF, suggests that DHEA may eventually be useful as a
therapy for depression.

In a study, 22 patients suffering from severe depression, as defined by
their ranking on the Hamilton Depression Rating Scale (HDRS), were given
either DHEA or placebo. After six weeks, patients were re-evaluated for
depression. While none of the 11 placebo recipients experienced a
significant improvement, five of the 11 DHEA recipients showed a
decrease of 50 percent or more in depressive symptoms, according to a
report of the study published earlier this year in the American Journal
of Psychiatry.

Results of an ongoing study of DHEA and depression conducted by
Wolkowitz and his UCSF colleague Dr. Louann Brizendine are expected to
be revealed next year.

DHEA was investigated as early as the 1950s, when studies indicated the
treatment may be beneficial for patients suffering from "inadequate
personality" and "emotional and constitutional immaturity." Interest in
DHEA gained momentum in the 1990s, but most studies have been on
animals, were not placebo-controlled, or involved only a small number of
people.

The mechanism by which DHEA elevates mood remains unclear but it is
generally believed that it acts as a "buffer" against the damaging
effects of cortisol, a hormone associated with stress. Interestingly,
while levels of DHEA decline with age, cortisol levels rise or remain
constant as people age.

DHEA is also believed to increase the brain chemical serotonin,
deficiencies of which have been implicated in depression. Finally, DHEA
is partially metabolized to estrogen and testosterone, hormones that
have also been linked to mood. While administered doses of estrogen and
testosterone may be beneficial for many people, they represent a red
flag to patients at risk of hormone-sensitive tumors such as cancers of
the breast, cervix, uterus and prostate.

"It is very prudent for [people in this risk group] to avoid DHEA," said
Wolkowitz. "People taking DHEA for several months or longer should be
medically followed for such tumors."

Copyright 1999 The Medical Tribune News Service. All rights reserved.
©1996-1999 Inteli-Health, Inc.
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Judith Richards, London, Ontario, Canada
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