Impact of exogenous testosterone on mood: a systematic review and meta-analysis of randomized placebo-controlled trials.

BACKGROUND In the last decade, there has been a surge of new clinical trials studying the impact of exogenous testosterone on mood. The results of these studies have been inconsistent. METHODS Meta-analysis of controlled clinical trials using common depression rating scales was performed. RESULTS Sixteen trials with a total of 944 subjects met selection criteria. Meta-analysis of data showed a significant positive impact of testosterone on mood (z=4.592; P<.0001). Subgroup analysis showed a significant effect size of 5.279 (P<.0001) in the trials with a mean age of <60 years. However, the effect size was not statistically significant in those trials with a mean age of >60 years. The effect size in hypogonadal men was 4.192 (P<.0001), whereas the result was not statistically significant in eugonadal men. In addition, the effect size was larger in subthreshold depression compared with major depression. Oral testosterone compared with oral dehydroepiandrosterone, testosterone gel, and intramuscular testosterone did not show a significant result. Larger CONCLUSIONS Testosterone may be used as a monotherapy in dysthymia and minor depression or as an augmentation therapy in major depression in middle-aged hypogonadal men.