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Prasterone (DHEA) and mania.

C E Dean1

  • 1Minneapolis Veteran's Affairs Medical Center, University of Minnesota Department of Psychiatry, 55417, USA. charles.dean@med.va.gov

The Annals of Pharmacotherapy
|January 6, 2001
PubMed
Summary
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Dehydroepiandrosterone (DHEA) use can trigger severe mania and psychiatric complications, particularly in individuals under 35. Clinicians should be aware of these risks, especially with high doses or pre-existing mood disorders.

Area of Science:

  • Neuroendocrinology
  • Psychiatry
  • Pharmacology

Background:

  • Dehydroepiandrosterone (DHEA) is an endogenous steroid hormone with a wide range of purported health benefits.
  • Despite its availability, the efficacy and safety of DHEA have not been fully confirmed by regulatory bodies.
  • DHEA is marketed for various conditions including AIDS, memory loss, and depression, often without reported serious adverse events.

Observation:

  • A case study details a 31-year-old man who developed severe mood and behavioral changes, including homicidal threats, after initiating DHEA use.
  • The patient had a history of episodic alcohol use and anger control issues, with a prior unsubstantiated diagnosis of bipolar disorder.
  • Despite initial improvement with valproate, the severity of his psychiatric symptoms necessitated involuntary commitment.

Related Experiment Videos

Findings:

  • Anabolic steroid use, including DHEA, is linked to significant psychiatric issues such as mania, psychosis, and cognitive impairment.
  • A subset of DHEA users may experience severe psychiatric symptoms, challenging previous reports of safety.
  • Potential risk factors for adverse psychiatric events include high DHEA dosage, a history of mood disorders, concurrent substance use, and genetic factors like cytochrome P450 polymorphisms.

Implications:

  • The use of DHEA may pose particular risks for individuals under 35, whose endogenous DHEA levels are naturally high.
  • Clinicians and researchers investigating DHEA must remain vigilant regarding its potential for severe psychiatric complications.
  • Healthcare providers should counsel patients on the potential risks associated with DHEA supplementation, especially in vulnerable populations.