Pregnant women, non-adults and people at high risk for or who have the following hormone-sensitive cancers should never use DHEA:
Some people with bipolar illness who use DHEA may experience mania that can lead to suicidal behaviour. Therefore, people with bipolar depression should not use DHEA.
In small, short studies in HIV positive people, DHEA appears to help relieve depression but this needs to be confirmed in large studies. As well, most studies of DHEA have been in middle-aged or elderly subjects. The safety of DHEA in younger subjects is not known. In PHAs, the safety of taking DHEA for more than four months is not known. Depending on the dose used, HIV positive people who have taken DHEA for less than four months have experienced at least one of the following side effects:
Because DHEA has not been well studied in PHAs, there may be other side effects. The impact of DHEA on signs/symptoms of the HIV lipodystrophy syndrome is not known. We do not know of any interactions between DHEA and medications commonly used by PHAs.
DHEA has not been approved by Canadian regulatory authorities. Health Canada considers DHEA to be a controlled substance. Products that fall under this category are available only with a doctor's prescription. If you and your doctor(s) decide that you need DHEA to maintain your health, have your doctor call or e-mail Health Canada's Special Access Programme and discuss ways of legally obtaining DHEA. The Special Access Programme may be contacted via telephone at 613-941-2108 (between 8:30 am and 4:30 pm Eastern Standard Time) or 613-941-3061 after 4 pm. E-mail: EDR_Drugs-BPA@hc-sc.gc.ca.
For more information about DHEA, you may wish to consult a doctor who specializes in the study of the body's hormones — an endocrinologist.
REFERENCES:
1. Horowitz S. Decoding the role of DHEA in health and longevity. Alternative and Complementary therapies 2000;June:129-134.
2. Wolkowitz OM, Reus VI, Keebler A, et al. Double-blind treatment of major depression with dehydroepiandrosterone. American Journal of Psychiatry 1999;156:646-649.
3. Dyner TS, Lang W, Geaga J, et al. An open-label dose-escalation trial of oral dehydroepiandrosterone tolerance and pharmacokinetics in patients with HIV disease. Journal of Acquired Immune Deficiency Syndromes 1993;6(5):459-465.
4. Rabkin JG, Ferrando SJ, Wagner GJ and Rabkin R. DHEA treatment for HIV+ patients: effects on mood, androgenic and anabolic parameters. Psychoneuoendocrinology 2000;25:53-68.
5. Jacobson MA, Rusaro RE, Galmarini M and Lang W. Decreased serum dehydroepiandrosterone is associated with an increased progression of human immunodeficiency virus infection in men with CD4 cell counts of 200-499. Journal of Infectious Diseases 1991;164(5):864-868.
6. Dean CE. Prasterone (DHEA) and mania. Annals of Pharmacotherapy 2000;34(12):1419-1422.
7. Peet M and Peters S. Drug-induced mania. Drug Safety 1995;12(2):146-153.
8. Christeff N, Melchior J-C, de Truchis P, et al. Lipodystrophy defined by a clinical score in HIV-infected men on highly active antiretroviral therapy: correlation between dyslipidaemia and steroid hormone alterations. AIDS 1999;13(16):2251-2260.
9. Legrain S, Massien C, Lahlou N, et al. Dehydroepiandrosterone replacement administration: pharmacokinetic and pharmacodynamic studies in healthy elderly subjects. Journal of Clinical Endocrinology and Metabolism 2000;85:3208-3217.
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Copyright © 2001 - TreatmentUpdate. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through the Editor, The Canadian AIDS Treatment Information Exchange, 555 Richmond St. West, Suite 505, Box 1104, Toronto, ON, M5V 3B1 • Phone: 416-203-7122 • Toll Free: 1-800-263-1638 • Fax: 416-203-8284 http://www.catie.ca.
AEGiS is made possible through unrestricted grants from Boehringer Ingelheim, Elton John AIDS Foundation, iMetrikus, Inc., the National Library of Medicine, and donations from users like you. Always watch for outdated information. This article first appeared in 2001. This material is designed to support, not replace, the relationship that exists between you and your doctor.
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