Schmidt Peter J, Berlin Kate L, Danaceau Merry A, Neeren Amy, Haq Nazli A, Roca Catherine A, Rubinow David R
Behavioral Endocrinology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892-1276, USA.
Arch Gen Psychiatry. 2004 Oct;61(10):997-1004. doi: 10.1001/archpsyc.61.10.997.
The effects of declining androgen secretion on mood regulation and the potential psychotropic efficacy of androgen replacement in men are largely undetermined.
To examine the effects on mood of the acute suppression of testosterone secretion.
A double-blind, placebo-controlled, crossover (self-as-own-control) study.
An ambulatory care clinic in a research hospital.
Thirty-one healthy adult men with no history of psychiatric illness or substance or anabolic steroid abuse.
Men received depot leuprolide acetate (Lupron, 7.5 mg intramuscularly) every 4 weeks for 3 months. After the first month of Lupron alone, all men received (in addition to Lupron) testosterone enanthate (200 mg intramuscular) or placebo (sesame oil as color-matched vehicle) every 2 weeks for 1 month each in a crossover design. The order of administration of testosterone and placebo was randomly assigned and counterbalanced.
Mood and behavior rating scores (self-report and rater administered).
With the exceptions of hot flushes, libido, and the feeling of being emotionally charged, none of the symptoms measured showed a significant difference across eugonadal, Lupron plus placebo, and Lupron plus testosterone conditions. Despite the absence of a uniform effect of Lupron plus placebo on mood, 3 men experienced clinically relevant mood symptoms during this induced hypogonadal condition. High baseline levels of sexual functioning predicted the greatest decline in sexual function during Lupron plus placebo.
These data, the first to describe the effects on mood of induced hypogonadism in healthy young men, suggest that short-term hypogonadism is sufficient to precipitate depressive symptoms in only a small minority of younger men. The predictors of this susceptibility remain to be determined.
雄激素分泌减少对情绪调节的影响以及雄激素替代疗法对男性潜在的精神治疗效果在很大程度上尚未确定。
研究睾酮分泌急性抑制对情绪的影响。
一项双盲、安慰剂对照、交叉（自身对照）研究。
一家研究医院的门诊护理诊所。
31名无精神疾病史、无药物或合成代谢类固醇滥用史的健康成年男性。
男性每4周接受一次长效醋酸亮丙瑞林（Lupron，7.5mg肌肉注射），共3个月。在仅使用亮丙瑞林的第一个月后，所有男性在交叉设计中每2周接受一次庚酸睾酮（200mg肌肉注射）或安慰剂（与亮丙瑞林颜色匹配的芝麻油），各持续1个月。睾酮和安慰剂的给药顺序随机分配并进行平衡。
情绪和行为评分（自我报告和评估者评定）。
除潮热、性欲和情绪激动感外，在性腺功能正常、亮丙瑞林加安慰剂以及亮丙瑞林加睾酮的情况下，所测量的症状均无显著差异。尽管亮丙瑞林加安慰剂对情绪没有一致的影响，但在这种诱导性性腺功能减退状态下，有3名男性出现了具有临床意义的情绪症状。性功能的高基线水平预示着在亮丙瑞林加安慰剂期间性功能下降最大。
这些数据首次描述了健康年轻男性诱导性腺功能减退对情绪的影响，表明短期性腺功能减退仅在少数年轻男性中足以引发抑郁症状。这种易感性的预测因素仍有待确定。
