Posted by BarbaraCat on January 12, 2002, at 21:31:25
In reply to Newsweek Article - new drugs, posted by Bill L on January 8, 2002, at 14:56:16
When was the last time your Pdoc asked about what you were eating? How your thyroid was doing? Your levels of DHEA or free cortisone levels and circadian surges? What time you get to sleep? How do you breathe?
OK, I've been following the CRF factor cortisol/HPA axis trail for some time and, while in theory it's promising, I can assure you that cortisol is not the lynchpin in all this - it's the EFFECT, not the cause. Cortisol is released by the adrenals - the adrenal medulla in fact, in response to stress, as well as the circadian rhythm/sleep cycle and light. Cortisol converts to noradreneline, which then travels by way of the cerebral spinal fluid to find it's way into the limbic system which then releases a surge of norepinephrine. A normal and healthy response to stress and motivational energy is dependant upon a healthy CRF/HPA in-sync system. It's a very useful catabolic hormone without which you would feel little energy and you would not break down and excrete old debris out of your system. Cortisol should normally be higher in the a.m. and lower in the p.m. The problem occurs when the parasympathetic (the fight/flight branch of the nervous system) system is chronically overstimulated and gets stuck in hyperarousal and fear mode and keeps churning out cortisol, especially at bedtime when it should be at a low tide. There's also a school of thought that says that all this churning out of cortisol/noradrenaline depletes our adrendal reserve which has to be restored and recovered through recuperation. It's not as easy as taking a pill to block cortisol - it comes down to looking at our lifestyle and healing any underlying metabolic dysfunctions. We simply don't know how to decompress and disconnect from the intense stress we're bathed in, whether it be our jobs, relationships or our depressions, and this takes it's toll. There are ways to address the root of these problems rather than apply bandaids via drug therapy after the fact. What needs to be addressed and IS NOT in psychiatry is some in-depth knowledge and testing in basic body health and lifestyle counseling (along with brain imaging scans!). What vitamins/herbs/amino acids/hormones, in specific and tailored therapeutic doses might target and support underlying metabolic dysfunctions? Is DHEA supplementation called for? Is there a sleep cyle dysregulation that might be helped with melatonin? EPA in fish oils seem to help excess cortisol. Breath training for hyperarousal. There are many other systems in our miraculous bodies that need attention.
I'm NOT saying medication isn't called for - I'd be incoherent without it and have needed big-guns drug therapy to get me to a place to look beyond it. However, we cannot expect pharmacology to do it all. We can't expect our very busy PDocs or MD's to know all the answers either. Let's start being very curious about all possible sources of our imbalances and what body systems they affect. There are trained folks who can delve deeper into these branches of healthcare than most of our typical care team has time for. I have personally been helped tremendously by eventually dragging my poor sick bod into good naturopath's office.
> The recent special double issue of Newsweek has an interesting article on new antidepressants being tested. The magazine is not dated. It has a graphic of September 11 on the cover. The researchers anticipate that the new drugs may eventually replace the SSRI's and other current drugs.
> The new drugs block cortisol. Cortisol is thought to cause shrinkage of a part of the brain known as the hippocampus. (I used to think that was a college for hippos). Autopsies show diminished hippocampuses (or is it hippocampi?) in depressed people. The idea is that the cortisol blocking drug will work better than current drugs with less side effects.
> There are other drugs that could more directly prevent shrinkage of the neurons in the brain but these drugs taken orally cannot be absorbed. Also, even if injected, they cannot cross the blood brain barrier. The corisol blocking drug however can be taken orally.
> This new drug caused less depression in rats. If you read the article it goes into detail of how one measures depression in rats. Apparently depressed rats drown more easily than happy rats.