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June 26, 2002

Depression in an Elderly Man—Reply

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthor

JAMA. 2002;287(24):3210-3211. doi:10.1001/jama.287.24.3206

In Reply: Dr Danby suggests low testosterone level as a possible cause of this patient's depression and associated symptoms. The endocrine disorder most commonly purported to be a secondary cause of depression is hypothyroidism and, even here, the evidence is inconclusive.1 Depression is common in older men, and there are inadequate data to indicate how often low testosterone levels would be the cause. I agree that if decreased libido is a primary symptom and, in particular, if the major depressive disorder does not readily respond to antidepressant treatment or psychotherapy, an evaluation for hypogonadism might be appropriate. Even in women, in whom perimenopausal mood disorders have been an important consideration, the relationship between depressive disorders and estrogen deficiency is uncertain.2

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