We appreciate the thoughtful letter from Dr Daly and his colleagues, and agree with their central point that our study does not provide justification for use of testosterone as a "routine treatment for depression." As we noted at the outset, this study was designed to assess the effects of testosterone on several hypogonadal symptoms reported by men with human immunodeficiency virus/acquired immunodeficiency syndrome, and was not intended as an efficacy trial for the treatment of depression. In fact, since alleviation of syndromal depression was not a primary study goal, we did not stratify for this diagnosis. However, in a previous study we reported improved mood in 34 men with dysthymia or major depression treated openly with testosterone, and no change in mood in those randomized to placebo, in a double-blind discontinuation phase.1 Together, these findings indicate that the antidepressant effects of testosterone warrant further study. Accordingly, we are now conducting a placebo-controlled double-blind trial of fluoxetine and testosterone for depressed men with human immunodeficiency virus infections.
Rabkin JG, Rabkin R, Wagner GJ. Testosterone's Effects Not Limited to Mood—Reply. Arch Gen Psychiatry. 2001;58(4):403-404. doi: