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Ask the Mental Health Expert Archives 2001-2004

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Dehydroepiandrosterone and Taurine

Q. I have dysthymia, major depression, general anxiety (with panic disorder), mild obsessive-compulsive disorder (OCD) and diabetes. I am also a recovering alcoholic. I am on 50 mgs of Zoloft per day. I also take tyrosine and zinc.

Can you tell me about DHEA and taurine, as an add on treatment? My doctor also just informed me that I have a very low testosterone level. How does this relate to my depression?

A. Let's take these questions one at a time. First, DHEA (dehydroepiandrosterone) is a naturally-produced hormone made by the adrenal gland. Men have higher levels of DHEA than women, and it declines with age. DHEA's precise role in the body is not entirely clear, and many extravagant claims have been made regarding DHEA as a fountain of youth, sexual stimulant, mood enhancer, etc. [For all the technical details, see the chapter by Wolkowitz and Reus in the book, Psychoneuroendocrinology, edited by Wolkowitz & Rothschild, 2003].

We do believe that DHEA has activity in the brain, and may affect mood and cognitive abilities. Some studies show that depression is associated with lower than average blood levels of DHEA; on the other hand, this may not be true in depressed patients who also have panic disorder (Goodyer et al, 1996). As Wolkowitz and Reus summarize the literature, "?in certain situations, DHEA administration enhances mood, energy, sleep, sense of well-being?and memory?such effects may be more likely in elderly, depressed, or infirm patients or in patients with markedly low DHEA levels...than in young, healthy, individuals."

So far, so good. But DHEA may also have side effects, and be risky in some patients. DHEA may be converted to testosterone (which may have implications in your case) and this may pose risks for men with enlarged prostrates; in theory, DHEA could increase the risk of prostatic cancer, though this has not been proven. Common side effects include acne, oily skin, nasal congestion, and headache. Less commonly, insomnia, over activation, aggression, and mania or psychosis can occur. So--we are not talking here about chicken soup!

Regarding your low testosterone: I don't know how that relates to your depression, but there are studies suggesting that testosterone gel may produce antidepressant effects in some depressed men with low testosterone levels (Pope et al, Am J Psychiatry. 2003 Jan;160(1):105-11). Again, there may be side effects and long-term risks associated with testosterone, so this is something to discuss very carefully with your doctor, perhaps in consultation with an endocrinologist or urologist.

Regarding taurine: this is an amino acid (a building-block of protein) that occurs naturally in the body, including the brain. There is some animal-derived evidence that taurine may help protect the liver against the damaging effects of alcohol, and may possibly affect craving for alcohol. A medication called acamprosate--not yet available in the US but expected soon--is derived from a chemical related to taurine, and appears to help reduce alcohol craving in some studies.

However, I am not aware of any studies in humans showing that taurine supplements can actually improve any of the conditions with which you have been diagnosed. You have a complex set of psychiatric problems, but the good news is, SSRIs (selective serotonin reuptake inhibitors, such as Zoloft, Paxil, Prozac, etc) are helpful with all of them--SSRIs may even help a bit with high blood sugar! How helpful these medications are in alcoholism depends on the specific population you study, but when depression co-exists with alcoholism, SSRIs may be helpful for both conditions.

January 2004

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