Dehydroepiandrosterone for depressive symptoms: a systematic review and meta-analysis

The data contained in the table were used to perform the meta-analysis whose abstract is as follows:

Objective: To investigate the effect of DHEA treatment on depressive symptoms in individuals with depression and/or other clinical conditions in which depressive symptoms are present.

Methodology: an electronic search was performed until August 2019, with no language or time restrictions of publication in the following databases: Medical Literature databases and Retrieval System Online (Medline), Excerpta Medical Database (EMBASE), Latin American and Caribbean Health Sciences (LILACS) e a Cochrane Library. Randomized controlled trials comparing any dose and form of DHEA versus placebo were included, regardless of treatment time since depressive symptoms were assessed at baseline and at the end of the study in individuals with depression and/or other psychiatric or medical conditions. Two authors independently extracted data after assessing eligibility for inclusion and study quality. Primary study authors were contacted for additional information.

Main results: fifteen studies with 853 individuals with a diagnosis of depression or depressive symptoms were included in this review. Data were extracted from 14 studies to conduct the meta-analysis. In comparison with placebo, DHEA improved depressive symptoms (standardized mean difference (SMD) -0.28, 95% (CI) -0.45 to -0.11, P = 0.001, 12 studies, 742 individuals (375 in the experimental group and 367 in the placebo group), I² = 24%), very low quality evidence, two studies out of 14 reporting this outcome were removed in a sensitivity analysis as they were strongly influencing heterogeneity between studies. No dangerous hormonal changes or significant side effects were observed.

Conclusion: DHEA was associated with a beneficial effect on depressive symptoms compared to placebo, however this effect was not equally observed in all studied populations, proving to be more effective especially in individuals diagnosed with depression or dysthymia with mild or moderate depressive symptoms.