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Editor's Correspondence
April 12, 2004

Sex Hormone Deficiency in Depressed Patients Receiving Opioids

Arch Intern Med. 2004;164(7):804. doi:10.1001/archinte.164.7.804-a

Since depression is a common symptom of sex-hormone deficiency and hypogonadism is quickly induced by opioid medications, the review of the relationships between pain and depression by Bair et al1 might logically have included a discussion of opioid-induced androgen deficiency (OPIAD). Opioids inhibit gonadotropin production in most men soon after beginning therapy with sustained-action oral,2 transdermal,3 or intrathecal4 opioids. A similar illness is present but less well documented in opioid-treated women.3,4

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