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Depression,sleep apnea,low testosterone,lethargy,irritable

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Practicing since : 2004
Answered : 1835 Questions
I was miss-diagnosed with depression a few years ago. My family doctor, prescribed Effexor, (and I didn't like the way it made me even more depressed). Then he prescribed Cymbalta, which didn't help. He thought that maybe I wasn't sleeping well, and I went to sleep study, and I do have sleep apnea) but I was still depressed. My family doctor tested my testosterone and found I had very low levels of free and total testosterone. Total testosterone was 128ng/dL.

For more than a year, I have been using Androgel, 2 - 5gram packets of 1% gel, per day.

With all this said, I remain worn out, lethargic, depressed, irritable, with decreased libido... I went to my family doctor two months ago, he doesn't know what else he could do; and he suggested I go to an endocrinologist. Last month, I went to an endocrinologist, and he said with the Androgel, I have the testosterone level of a 25 year old. Total testosterone was 713ng/dL. I dont feel like a 25 year old.

I am thinking of HGH.

age: 50
height/weight: 6'3" / 260 pounds
Posted Tue, 8 May 2012 in Mental Health
Answered by Dr. Ashish Mittal 4 hours later

Thanks for your query.

In your case there are some important points:
· Skin cancer: Basal cell and Squamous cell
· Past history of Surgery - Moh's, hernia, tonsillectomy
· Currently on Androgel leading to high testosterone level
· OTC supplements: Night time sleep aid. CPAP
· Presence of depression

You have given well description of Depression in your history but cause may be multiple like presence of multiple co morbidity and drugs.
Although you started treatment for Depression but you stopped in between because of side effects or no effects experienced by you. Antidepressants (Effexor and Cymbalta) usually start showing its effects in 3-4 weeks when given in adequate doses. In your cases there may be possibilities that you have not taken treatment for Depression in adequate doses and for sufficient duration. If one or two drug does not relieve you then there are lots of other medicines available.
About the testosterone level around 550 ng/dl is ok for you. In a case of depression patient usually have decreased libido and erectile dysfunction. So treatment with only Androgel is not sufficient for you as it has no effect on depression. We cannot advise medication on this forum but I can tell you that consultation with psychiatrist will help you greatly.

Wish you Good Health

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