Over-the-Counter Supplement Appears Effective in Treatment of Midlife-Onset Depression  Health Care

February 10, 2005 — The over-the-counter hormonal therapy known as DHEA may be an effective treatment of midlife-onset minor and major depression, according to a study in the February issue of The Archives of General Psychiatry, a journal of the American Medical Association. DHEA (dehydroepiandrosterone), an adrenal androgen and neurosteroid is available as a supplement in the United States.

Complementary and alternative medicine is a multimillion dollar industry, reflecting a growing number of people who avoid traditional medication, including anti-depressants, according to information provided in the article. Alternative therapies may have potential as second- or third-line treatments but controlled evaluations of these potential therapeutic agents are needed, the study's authors suggested. DHEA has been previously reported to have antidepressant-like effects. The current study was designed to evaluate DHEA as a treatment for depression with a midlife onset.

23 men and 23 women aged 45 to 65 with midlife onset major or minor depression of moderate severity,were evaluated. They were randomly assigned to either receive six weeks of DHEA therapy, three weeks each of two dosages, or six weeks of placebo treatment. Following the six weeks of DHEA therapy and a period of one or two weeks without any therapy, the treatment groups were reversed. The participants in the study were evaluated at three and six weeks during the treatment phases with standard measures of depression and a sexual functioning scale.

A 50 percent or greater reduction in the baseline of their score on a depression rating scale was observed in 23 patients after DHEA and in 13 patients after placebo. Six weeks of DHEA treatment was associated with significant improvements in measures of depression and sexual functioning compared to both baseline and six weeks of placebo treatment, the researchers found.

In conclusion,there are no predictors of response, and with a 50 percent response rate one would obviously select more reliable first-line treatments for this condition. However, in the 50 percent of depressed outpatients who do not respond to first-line antidepressant treatment, or in those unwilling to take traditional antidepressants, DHEA may have a useful role in the treatment of mild to moderately severe midlife-onset major and minor depression.

Understanding Prostate Changes: A Health Guide for Men Healthy Men

Introduction to the Prostate
You may be reading this article because you are having prostate problems. The article can help answer your questions about prostate changes that happen with age, such as: What are common prostate changes? How are these changes treated? What do I need to know about testing for prostate changes, including cancer?

This article can give you basic information about common prostate changes. If you are making decisions about prostate cancer treatment, there are other resources available. See the Additional Resources section.

What Is the Prostate?
The prostate is a small gland in men. It is part of the male reproductive system.  The prostate is about the size and shape of a walnut. It sits low in the pelvis, below the bladder and just in front of the rectum. The prostate helps make semen, the milky fluid that carries sperm from the testicles through the penis when a man ejaculates. The prostate surrounds part of the urethra, a tube that carries urine out of the bladder and through the penis. How does the prostate change as you get older? The prostate gland surrounds the tube (urethra) that passes urine. This can be a source of problems as a man ages because: The prostate tends to grow bigger with age and may squeeze the urethra (see drawing). A tumor can make the prostate bigger. These changes, or an infection, can cause problems passing urine. Sometimes men in their 30s and 40s may begin to have these urinary symptoms and need medical attention. For others, symptoms aren't noticed until much later in life. Be sure to tell your doctor if you have any urinary symptoms.

Tell your doctor if you :
Are passing urine more during the day
Have an urgent need to pass urine
Have less urine flow
Feel burning when you pass urine
Need to get up many times during the night to pass urine

What Prostate Changes Should You Be Aware Of?
Growing older raises your risk of prostate problems. The three most common prostate problems are:

Infection (prostatitis)
Enlarged prostate (BPH, or benign prostatic hyperplasia)
Prostate cancer
One change does not lead to another. For example, having prostatitis or an enlarged prostate does not raise your chance of prostate cancer. It also is possible for you to have more than one condition at the same time.
What Are Common Tests for Prostate Changes?

Abnormal findings from any of these tests can help diagnose a problem and suggest the next steps to take: