Testosterone Replacement in Middle-Aged Hypogonadal Men With Dysthymia: Parallel Group, Double Blind Randomized Trial

Inclusion Criteria: 1. Male, age 40-80 years. 2. Diagnosed with hypogonadism (total T level below 350 ng/dl), but not previously treated. 3. Diagnosis of Dysthymic disorder with onset after age 40. 4. PSA \< 4.0. 5. Normal digital exam of the prostate in the preceding 1 year. 6. For subjects currently taking an antidepressant: Current antidepressant treatment last 6 weeks or longer, with decent dose and with no remission (or with partial remission only HAM-D \> 12). 7. Able to give informed consent. Exclusion Criteria: 1. Acute, severe, or unstable prostatitis, symptomatic prostatic hypertrophy, polycythemia, severe acne, breast cancer, prostate cancer, or hypopituitarism. 2. Currently being treated with testosterone. 3. Meets lifetime criteria for schizophrenia, schizoaffective disorder, any bipolar disorder (i.e., BP-I, BP-II, or BP NOS); or a major depressive episode in the preceding 5 years. 4. Current suicidal risk. 5. Current (past year) substance abuse or dependence.