Dehydroepiandrosterone replacement therapy

Abstract

Purpose of reviewThe option of dehydroepiandrosterone (DHEA) replacement has attracted considerable attention from rather different perspectives over recent years. This review summarizes recent findings from randomized controlled trials. Recent findingsThe clinical impact of DHEA replacement was defined in patients with adrenal insufficiency, the pathophysiological model population for complete DHEA deficiency, and recent studies have confirmed beneficial effects of health-related quality of life and mood. The neurosteroidal properties of DHEA suggest anti-depressant action and several studies in patients with neuropsychiatric disorders have confirmed this. Important advances have been made regarding the use of DHEA in patients with chronic autoimmune disease, DHEA treatment in systemic lupus erythematosus in phase II and III trials has resulted in reduced disease activity, reduction in glucocorticoid dosage and maintenance of bone mineral density. SummaryDHEA is a useful tool for female androgen replacement, in particular in women with adrenal insufficiency. Its neurosteroidal properties merit further studies in depressive disorders and anorexia nervosa. Studies in systemic lupus erythematosus have begun to define the usefulness of DHEA as a therapeutic, immune modulatory drug. Caution is required, however, regarding the use of DHEA in healthy elderly persons as current evidence does not justify the use of DHEA in this context.