Posted by OldSchool on March 26, 2002, at 18:47:54
In reply to Re: AD meds and BP response » OldSchool, posted by JohnX2 on March 26, 2002, at 13:29:52
> > Here is my own prediction concerning my upcoming ECT. How much do you wanna bet that my blood pressure goes down a lot after ECT because I will be more relaxed? I think ECT will help my BP.
> From what I was reading about high blood pressure, it is often associated with a excess glucorcorticoid production state (do a web search). This may linked to a hyperacitive HPA (hypothalamaus-pituitary-adrenal-gland) axis. This is consistent with classic markers of depression. Hyperadrenal gland can cause dysfunctional noradrenargic system in general. You can acutally get this tested. The glucocorticoid receptors in the hypothalamus etc are desensitized to cortisol feedback and release too much of a substance ACTH. These causes too much secretion of cortisol (and high blood pressure) and continued depression. It may also make you agitated. CRF antagonists may fix this. Most ADs over time are thought to correct a malfunctioning feedback loop in the HPA axis. I would hope this would have an effect of fixing a hypercorisolemia state and possibly helping your bp. BTW, some people believe that NMDA antagonists may act as atypical CRF antagonists.
> I believe some of the dopamine agonists reduce noradrenergic output by stimulating presyaptic d2/d3 recptors at the lower doses. Pramipexole I seem to recall has hypotensive effects at low doses (at is selective for presynaptice autoreceptors. At the higher doses, they are less selective and stimulate the post synaptic d2 receptors If I recall (may lead to the psychosis). I believe Bromocriptine depletes noradrenaline release at the lower doses.
> This is all my quick-n-dirty conjecture, as always.
> Have you tried a mild atypical bp medicine like an alpha-2 agonist (clonidine, tenex)? This reduces norepinephrine release. Maybe a good handshake with an NRI AD. (OK a SWAG).
Yes, someone who is a doctor recently told me that when you have high blood pressure huge amounts of adrenaline are fluctuating in your body. Actually several MDs have told me this. I have tried Klonidine briefly, while in the hospital. It was a horrid medication. Extremely sedating. Its another old, dirty drug not used much anymore, like tricyclic antidepressants. I much prefer the modern class meds with good side effect profiles like ACE Inhibitors. But I know what your point is and know what you are trying to get at.
You are probably right. All of this stuff is probably somehow related. Stress does all kinds of nasty things to the body...and the brain. Maybe 100 years from now doctors will have all this stuff figured out. Unfortunately, medical research moves so slowly I doubt any of us will live to see this kind of stuff evolve into anything real world. The corticosteroid theories and ideas are real hot now, but still purely research and experimental. To my knowledge, there is not one single real anti-corticosteroid drug available for any psychiatric disorder or for hypertension or anything else.
There is one weird drug I read about thats available its used to induce abortions. Its a corticosteroid antagonist. I read a Medline abstract that said it could be used to fight psychotic depression. Thats the only drug I know of thats currently available like that and there is no way Im putting a drug marketed for that in my body.
Like I said...maybe in fifty more years this stuff will pan out finally.