NEW YORK (Reuters Health) - Pharmacologically induced reductions in testosterone do not appear to adversely affect mood in most healthy young men, according to a new report.

"The effects of declining androgen secretion on mood regulation and the potential psychotropic efficacy of androgen replacement in men are largely undetermined," Dr. Peter J. Schmidt and colleagues from the National Institutes of Health, Bethesda, Maryland, write in the October issue of the Archives of General Psychiatry.

In a double-blind, placebo-controlled, crossover study, the researchers examined the effects on mood of the acute suppression of testosterone secretion in healthy men. A total of 31 men with no history of psychiatric illness or anabolic steroid abuse were included in the study.

The men received 7.5 mg intramuscular depot leuprolide acetate (Lupron) every 4 weeks for 3 months. After the first 4 weeks, the men were randomly assigned to receive, in addition to Lupron, 200 mg intramuscular testosterone enanthate or placebo every 2 weeks for 1 month each in a crossover design. Main outcome measures included mood and behavior rating scores.

Significant increases in hot flush severity and significant decreases in sexual interest and the feeling of being "emotionally charged" were observed during Lupron plus placebo phase compared with baseline and Lupron plus testosterone phase. However, no significant differences in sadness, anxiety, irritability, anhedonia or decreased energy were seen between the Lupron plus placebo and the Lupron plus testosterone groups.

The investigators did not observe a uniform effect of Lupron plus placebo on mood. However, three men experienced clinically significant mood symptoms during the artificially induced hypogonadal condition.

"Men with high baseline sexual interest had a significant decrease in sexual interest during Lupron plus placebo (p < 0.01), and levels of sexual interest were restored to baseline levels during Lupron plus testosterone," Dr. Schmidt and colleagues report.

"Overall, our data suggest that acute androgen withdrawal, while associated with decreased libido and hot flushes, is not sufficient to uniformly alter mood in healthy young adult men."

Arch Gen Psychiatry 2004;61:997-1004

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