Short answer: It is reported, though in a small share of men at prescribed doses. In the 84-week Aveed study, 2% reported irritability, 2% mood swings and 1.3% aggression. The Xyosted label warns about depression and suicidal thoughts after 4 of 283 men (1.4%) had depression needing to stop or a suicide attempt. Serious psychiatric effects, including aggression and mania, are listed mainly for misuse at doses above those prescribed.
| Product | Source | What was reported |
|---|---|---|
| Aveed (undecanoate, every 10 weeks) | 84-week study, 153 men | Irritability 2%, mood swings 2%, aggression 1.3%, insomnia 2%; mood swings led one or more men to stop |
| Xyosted (enanthate, weekly) | Two studies, 283 men, up to 1 year | Depression needing to stop in 2 men; suicide attempts in 2 more (1.4% in total) |
| Depo-Testosterone, enanthate vial | Androgen side-effect list | Anxiety, depression, increased or decreased libido; no rates |
| Kyzatrex (oral) | 12-month open-label study | Anxiety listed, no rate |
| Aveed | Reports after approval | Aggression, anxiety, depression, irritability, nervousness, restlessness, sleep problems |
Rates from different products and studies cannot be directly compared, and the labels say so. Studies without a placebo group cannot show how much of a symptom the medicine caused.
Xyosted is the only one of these labels with a Warnings and Precautions section on depression and suicide. It says depression and suicidal thoughts and behavior, including a completed suicide, occurred in its clinical trials. It advises patients and caregivers to get medical attention for suicidal thoughts or behavior, new or worsening depression, anxiety or other mood changes, and asks prescribers to tell patients to report changes in mood.
Every injectable testosterone label has a section on abuse. It says serious psychiatric effects have been reported in people who misuse anabolic steroids, including major depression, mania, paranoia, psychosis, delusions, hallucinations, hostility and aggression, and lists irritability and hypomania among other reports in men. The labels note these reports may include misuse of other drugs and come from a population of unknown size.
The labels also describe withdrawal in people taking above-prescribed doses: depressed mood, major depression, fatigue, craving, restlessness, irritability, poor appetite, insomnia and low libido, lasting weeks or months after stopping or cutting the dose sharply. They say dependence has not been documented at approved doses for approved uses.
The labels do not say whether mood effects follow the peaks and troughs of an injection cycle. A simple daily mood rating logged against your injection days can show whether irritability clusters a day or two after a shot or late in the cycle, which is the kind of pattern a prescriber may use when looking at dose or schedule. The weekly vs twice-weekly injections page covers what is known about schedules.
Other notes worth bringing: sleep, alcohol, life stress, other medicines, and recent testosterone, estradiol and hematocrit results with dates. Dose Track lets you rate mood each day next to your dose log.
Read more on Dose Track: TRT symptom tracker: what to log · Estradiol on TRT · Weekly vs twice-weekly TRT injections · Aveed side effects · Xyosted side effects