Use of Testosterone Propionate in Treatment of Involutional Psychosis in the Male

Illicit anabolic–androgenic steroid use

“…Also by the late 1930s and early 1940s, testosterone and its relatives were widely prescribed to treat depression in psychiatric patients, and were hailed as a possible cure for the “male climacteric” (Altschule and Tillotson, 1948; Barahal, 1938; Danziger et al, 1944; Davidoff and Goodstone, 1942; Guirdham, 1940; Zeifert, 1942). By the 1950s, however, with widespread use of electroconvulsive therapy and the introduction of tricyclic antidepressants and monoamine oxidase inhibitors, AAS largely disappeared from psychiatric practice (Kanayama et al, 2007a), save for a few small trials in depressed men in the 1980s (Itil et al, 1984; Vogel et al, 1978; Vogel et al, 1985).…”

Age-Associated Testosterone Decline in Men: Clinical Issues for Psychiatry

“…In the late 1930s, subsequent to the isolation of various androgens (9), reports were published on treatment of the male climacteric and involutional melancholic symptoms with testosterone. Schmitz (10) noted improvement in a majority of middle-aged and elderly men with complaints of impotence and depres-HARVEY STERNBACH sion when they were treated with testosterone propionate, while Werner (12) noted the relief of fatigue, anxiety, and depression in two men with symptoms of the "climacteric" treated with the same form of testosterone. The problem in these and other reports (12)(13)(14) on the use of testosterone in men with climacteric symptoms or involutional melancholia was that many reports were of open-label treatment, for different periods of time, of patients who had varying mixtures of signs and symptoms.…”

“…Schmitz (10) noted improvement in a majority of middle-aged and elderly men with complaints of impotence and depres-HARVEY STERNBACH sion when they were treated with testosterone propionate, while Werner (12) noted the relief of fatigue, anxiety, and depression in two men with symptoms of the "climacteric" treated with the same form of testosterone. The problem in these and other reports (12)(13)(14) on the use of testosterone in men with climacteric symptoms or involutional melancholia was that many reports were of open-label treatment, for different periods of time, of patients who had varying mixtures of signs and symptoms. In addition, not all reports were of positive results (15,16), and as noted by Bharke et al (9), the American Medical Association's Council on Pharmacy and Chemistry stated in 1939 that "the involutional melancholia of males, for which testosterone has been suggested, has not been subjected to adequate trials to justify androgenic therapy other than on an experimental basis."…”

Thyroid Hormone Treatment of Depression

“…Earlier, open-label studies suggested that androgens may be effective for treating depression, especially in men who are hypogonadal. 62-65 Recently, there have been several studies using controlled designs where testosterone was used to treat depression in men who were hypogonadal or had low normal levels of testosterone. Testosterone was administered as monotherapy or else as an adjunct to conventional antidepressants.…”

“…The limited database and inconclusive findings in some studies have to be weighed against the known side effects of testosterone administration such as hypertension, gynecomastia, and polycythemia as well as the fact that treatment emergent paranoid symptoms have been infrequently reported especially in earlier studies. 62-65 The potential increased risk for prostate cancer with longterm testosterone treatment remains an unresolved issue. 75,76 …”