How do I install the Icsm Avoid Tt For Depressive Disorders skill?

Run npx skillmds@latest add dromlakhani/icsm-avoid-tt-for-depressive-disorders in your terminal (requires Node.js), paste this page's agent-chat prompt into Claude, Cursor, or any MCP-connected agent, or download the SKILL.md file and copy it into your agent's skills directory.

Is Icsm Avoid Tt For Depressive Disorders safe to use?

This skill has not completed SkillMD's automated safety review yet. Independent scanners report: SkillSpector: PASS, Skill Scanner: PASS. Capability flags: makes network calls. SkillMD never runs a skill's scripts for you; review the SKILL.md before installing.

Which AI agents work with Icsm Avoid Tt For Depressive Disorders?

This skill is tagged as working with Claude Code, Claude.ai, OpenAI Codex. SKILL.md is an open format, so most agents that read a skills directory can load it too.

Is Icsm Avoid Tt For Depressive Disorders free to use?

Yes. Installing skills from SkillMD is free, and the skill stays under its author's original license.

Who published Icsm Avoid Tt For Depressive Disorders?

dromlakhani (@dromlakhani) published this skill. Their other Agent Skills are listed on their SkillMD profile.

Icsm Avoid Tt For Depressive Disorders by dromlakhani

Name: Icsm Avoid Tt For Depressive Disorders
Rating: 4.2 (5 reviews)
Author: dromlakhani

Icsm Avoid Tt For Depressive Disorders

Testosterone monotherapy is not an effective treatment for clinical depressive disorders in hypogonadal men and should not be used for that purpose. Consider this when a patient presents with depressive mood and low testosterone, questioning whether testosterone will improve depression or if depression should be treated separately.

dromlakhani Updated Sep 8, 2026 10 repo stars

File contents

Avoid testosterone therapy alone for treating clinical depressive disorders

STEP 1 — Gather Information

Collect a structured depression assessment (e.g., PHQ-9), morning total testosterone level (fasting, 07:00–11:00), and document hypogonadism symptoms (low libido, erectile dysfunction, fatigue, decreased vigor). Rule out medical mimics of depression (thyroid disorders, anemia, medication effects).

STEP 2 — Rule In / Rule Out

Is a clinical depressive disorder diagnosed per DSM-5/ICD-10 criteria? If YES, proceed to Step 3; if NO, consider testosterone therapy for hypogonadism symptoms (if confirmed) and manage accordingly.

STEP 3 — Classify or Stratify

Classify depression severity using PHQ-9: mild (5–9), moderate (10–14), moderately severe (15–19), severe (20–27). If mild, consider psychotherapy or watchful waiting; if moderate-severe or greater, initiate evidence-based antidepressant therapy or refer to mental health specialist.

STEP 4 — Decide

Do not prescribe testosterone monotherapy for depression; treat depression with guideline-concordant antidepressants/psychotherapy, and consider testosterone therapy only for hypogonadism symptoms after depressive disorder is adequately treated.

Clinical Guardrails / Mimics / Pitfalls

Do not attribute depressive symptoms solely to low testosterone; avoid using TTh as a sole antidepressant; monitor for worsening depression or emergent suicidality; ensure depression is treated per psychiatric guidelines before addressing hypogonadism.

Concrete Clinical Example

A 52-year-old man reports fatigue, low libido, and morning total testosterone 8 nmol/L. PHQ-9 score is 15 (moderately severe depression). He asks if testosterone will improve his mood. According to the guideline, do not start testosterone therapy alone; initiate an SSRI, reassess mood in 4–6 weeks, and consider testosterone only for hypogonadism if depressive symptoms remit.

Source: Male hypogonadism: recommendations from the Fifth International Consultation on Sexual Medicine (ICSM 2024), Box2 Recommendation 14, 2025, https://doi.org/10.1093/sxmrev/qeaf036

---name: icsm-avoid-tt-for-depressive-disordersdescription: Testosterone monotherapy is not an effective treatment for clinical depressive disorders in hypogonadal men and should not be used for that purpose. Consider this when a patient presents with depressive mood and low testosterone, questioning whether testosterone will improve depression or if depression should be treated separately.---# Avoid testosterone therapy alone for treating clinical depressive disorders## STEP 1 — Gather InformationCollect a structured depression assessment (e.g., PHQ-9), morning total testosterone level (fasting, 07:00–11:00), and document hypogonadism symptoms (low libido, erectile dysfunction, fatigue, decreased vigor). Rule out medical mimics of depression (thyroid disorders, anemia, medication effects).## STEP 2 — Rule In / Rule OutIs a clinical depressive disorder diagnosed per DSM-5/ICD-10 criteria? If YES, proceed to Step 3; if NO, consider testosterone therapy for hypogonadism symptoms (if confirmed) and manage accordingly.## STEP 3 — Classify or StratifyClassify depression severity using PHQ-9: mild (5–9), moderate (10–14), moderately severe (15–19), severe (20–27). If mild, consider psychotherapy or watchful waiting; if moderate-severe or greater, initiate evidence-based antidepressant therapy or refer to mental health specialist.## STEP 4 — DecideDo not prescribe testosterone monotherapy for depression; treat depression with guideline-concordant antidepressants/psychotherapy, and consider testosterone therapy only for hypogonadism symptoms after depressive disorder is adequately treated.## Clinical Guardrails / Mimics / PitfallsDo not attribute depressive symptoms solely to low testosterone; avoid using TTh as a sole antidepressant; monitor for worsening depression or emergent suicidality; ensure depression is treated per psychiatric guidelines before addressing hypogonadism.## Concrete Clinical ExampleA 52-year-old man reports fatigue, low libido, and morning total testosterone 8 nmol/L. PHQ-9 score is 15 (moderately severe depression). He asks if testosterone will improve his mood. According to the guideline, do not start testosterone therapy alone; initiate an SSRI, reassess mood in 4–6 weeks, and consider testosterone only for hypogonadism if depressive symptoms remit.**Source:** Male hypogonadism: recommendations from the Fifth International Consultation on Sexual Medicine (ICSM 2024), Box2 Recommendation 14, 2025, https://doi.org/10.1093/sxmrev/qeaf036

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