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Fluoxetine treatment and testosterone levels.

Stewart Bell1, Mark Shipman, Alexander Bystritsky

  • 1Private practice, Arcadia, CA, USA. sbellmd@hotmail.com

Annals of Clinical Psychiatry : Official Journal of the American Academy of Clinical Psychiatrists
|March 7, 2006
PubMed
Summary

Selective serotonin reuptake inhibitors (SSRIs) like fluoxetine did not significantly alter testosterone levels in a pilot study of depressed patients. Further research is needed to explore potential links between SSRI treatment, testosterone, and apathy.

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Area of Science:

  • Endocrinology
  • Psychopharmacology

Background:

  • Previous case studies suggest a link between serotonin reuptake inhibitors (SRIs) and low testosterone levels.
  • Apathy and low testosterone resolved upon venlafaxine discontinuation in one reported case.
  • No prior studies have examined the impact of chronic SRI treatment on human testosterone levels.

Purpose of the Study:

  • To investigate the effect of fluoxetine, a common SRI, on testosterone levels in patients with depressive disorders.
  • To explore the relationship between testosterone levels and apathy in depressed patients.

Main Methods:

  • A pilot study involving 14 patients with depressive disorder and 4 non-depressed controls.
  • Baseline testosterone levels and apathy scores were recorded.
  • Patients received fluoxetine (10 mg/day for 7 days, then 20 mg/day) for one month.

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  • Follow-up testosterone levels were measured after one month of treatment.

    • Main Results:

    • No statistically significant relationship was found between fluoxetine treatment and overall changes in testosterone levels in either depressed (p = 0.4) or non-depressed (p = 0.3) patients.
    • Individual testosterone levels showed variability, with both increases and decreases observed.
    • A significant association was found between baseline testosterone levels and apathy scores in patients with a BDI score of 20 (p = 0.0033).

    Conclusions:

    • Fluoxetine treatment did not appear to significantly alter testosterone levels in this pilot study population.
    • Larger studies are warranted to investigate the correlation between testosterone changes during SRI treatment and treatment response, apathy, and sexual dysfunction.
    • The association between testosterone and apathy warrants further investigation in the context of antidepressant treatment.