DHEA.

Nutraceutical: DHEA

Indication: Non-major depression in HIV/AIDS patients

Source: Am J Psychiatry, January 2006;163(1):59-66.

Research: This study was designed to assess the efficacy of dehydroepiandrosterone (DHEA) as a potential treatment for non-major depression in 145 HIV/AIDS patients. Subjects were randomly assigned to receive either DHEA or placebo; 90% (69 of 77) of the DHEA patients and 94% (64 of 68) of the placebo patients completed the eight-week trial. The primary measure of efficacy was a Clinical Global Impression improvement rating of 1 or 2 (much or very much improved). plus a final Hamilton Depression Rating Scale score <or = 8. Safety was assessed by queries about side effects at every study visit plus measures of CD4 cell count and HIV RNA viral load at baseline and week eight. DHEA dosing was flexible (100-400 mg/day).

Results: On the basis of clinicians' ratings, DHEA was superior in the intent-to-treat analysis, where the response rate was 56% (43 of 77) for the DHEA group versus 31% (21 of 68) for the placebo group. In the completer analysis, the response rate was 62% (43 of 69) for the DHEA group, compared to 33% (21 of 64) for placebo patients. Non-major but persistent depression is common in patients with HIV/AIDS, and the authors of this study believe DHEA may be a useful treatment that is superior to placebo in reducing depressive symptoms. Additionally, the low attrition rate in this group of physically ill patients, together with requests for extended open-label treatment, reflect high acceptance of this readily available intervention.