- 7 - keto DHEA (3-acetyl- 7 - oxodehydroepiandrosterone) is marketed as a form of DHEA that
presents less risk of side effects. While 7-keto DHEA does not increase the level of steroid
hormones in the blood, no clinical studies to demonstrate either its efficacy or its safety
have yet been completed. PubMed reports only three published studies of 3 - acetyl- 7 - oxo-
dehydroepiandrosterone, of which only one deals with a mental health use.
5. EFFICACY: DEPRESSION AND BIPOLAR DISORDER:
Brown et al. refer to DHEA and 7-keto DHEA as promising CAM therapies for relief of
depression and bipolar disorder. Despite the potential for hormonal effects, Brown et
al. state that DHEA is “generally well tolerated.” 7-keto DHEA is being used as an
alternative to reduce the risk of side effects, but there is only one randomized study of
its efficacy or safety.
Brown et al. cite three studies and give a clinical anecdote to support the use of DHEA
for depression and bipolar disorder.^1 They cite evidence for the use of DHEA in bipolar
disorder but caution that: “DHEA should be used with caution and only in low doses in
bipolar patients because it can exacerbate mania, irritability, and aggression." Until it
is proven safe, this caution applies to 7-keto DHEA as well.
Brown et al. conclude that: “Although the evidence for 7-keto DHEA treatment is
preliminary, considering the severity of these conditions and low risk of side effects, it
is worthwhile to obtain DHEA and DHEA sulfate levels in patients with bipolar disorder
... or mid- to late-life depression. While laboratory reports indicate a normal range of
20 to 200 mg/dl, if the DHEA sulfate is below 200, it may still be worth a trial of 7-keto
DHEA using 25 to 50 mg per day. If symptoms persist, the dose may be gradually
raised up to 200 mg per day.”^2
Mischoulon and Rosenbaum explore all of the trials of DHEA since 1952, focusing on
depression, schizophrenia and dementia, showing the trials to be too short, too small
and too poorly controlled to serve as an evidence base for clinical use of DHEA. Dosage
and the means of administration proved also to be controversial. DHEA and DHEA-S (for
sulfate) levels in the blood often correlate with mood, memory and functional abilities,
