Testosterone prescribing in men with depression and anxiety disorders

Purpose: Testosterone replacement therapy (TRT) is posited to reduce the risk of depression and anxiety. To our knowledge, this is the first study to assess incident TRT prescribing patterns in a nationally representative sample of men with depression and anxiety in the United States. Methods: This study included 5,565,649 men aged 40–65 years, who were enrolled in Clinformatics Data Mart between January 1, 2002 and December 31, 2016. For each calendar year, we reported incident TRT prescribing and testosterone laboratory testing rates in men diagnosed with depression and/or anxiety. Results: For each calendar year, incident TRT prescribing rates were higher for men with depression and anxiety, than for men without these disorders. For both groups, TRT prescribing increased by 200% from 2002 to 2013 and decreased by more than 50% from 2013 to 2016. More than 20% of men in either group did not have a laboratory test for testosterone levels before TRT initiation. Conclusions: In men with depression and anxiety, TRT prescribing increased significantly from 2002 to 2013 and decreased from 2013 to 2016. A significant proportion of men were prescribed TRT without a prior laboratory test for testosterone levels. Further research is needed to better understand the extent to which these conditions influence physician prescribing practices and patient expectations.