Can Andriol Affect Moods?
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Q:  Can Andriol Affect Moods?

Dr. Phelps, I have been diagnosed with bipolar II and ADHD. I'm a 62 year old male and 2 years ago, I had my testosterone level checked due to low libido and it was dramatically low so my GP figured that it could help with my depression. So he put me on 240 mgs of Andriol caps daily. I would like to know if it could affect moods? Thank you 

Dear Robert --
Two thoughts on this.  First, we have no data on the significance of testosterone levels at any age relative to mood.  Is it really true, we should ask, whether low testosterone levels are associated with depression?

I wasn't sure about that answer, so I took a look at the national Library of medicine database.  A recent review linked the testosterone deficiency and depression. Tostain But another equally recent pair of reviews disputed the link. Amiaz, Ebinger  The language of the latter two reviews sounds more authoritative to me, more broad in view (just based on the abstract).  For now, I think we could conclude that the link between testosterone deficiency and depression is not clearly established, but that there may indeed be some men in whom low testosterone levels are a contributor to depression.

Of course the next question is whether anyone has clearly shown that giving testosterone can improve depression. Another recent review of that issue raises doubt, but again notes that it may be possible that some men, particularly older men, with low testosterone levels, may see mood benefit from testosterone treatment.Kanayama

And then finally, we come to the most pertinent question (my second thought): do we have any reason to be concerned that testosterone treatment for depression in Bipolar II might have more negative effects then the same treatment might cause in people with (unipolar) "major depression"?  Unfortunately, the answer here is similarly foggy.  Certainly we know that other steroid hormones can make bipolar disorder wars, namely prednisone, for example when it is given for asthma, or poison oak.  Likewise we also know that another pair of steering hormones, estrogen and progesterone, are clearly involved in shifts in mood -- not just "PMS", but worsening of mood symptoms after childbirth, so-called postpartum depression; worsening of mood symptoms at perimenopause; and even the onset of mood symptoms with the onset of menstrual cycling. In all these conditions, are working presumption is that shifting levels of such hormones is associated with a worsening of underlying mood syndromes, and it strongly appears that bipolar disorder is more likely to be destabilized in this way than unipolar major depression.

And so, can taking 240 mgs of Andriol affect mood? To summarize, I would say that from my experience, and based on this quick literature review, a beneficial effect is possible, and a negative effect is also possible.  We don't have the numbers to quantify how possible those outcomes are. 

Mind you, don't stop it on the basis of my comments here.  You take this information and discuss it with your physician, of course.  Either way, I hope you get a good outcome --

Dr. Phelps

Published November, 2008

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