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Re: cortisol considerations (long)

Posted by EarlyWakening on September 9, 2002, at 22:48:21

In reply to cortisol considerations (long), posted by Pfinstegg on September 8, 2002, at 18:17:47

> I have been lurking on the sites here for about a month and have learned a tremendous amount about the neurophysiology of depression, as well as often being moved by how much strength everyone is exhibiting, and how much caring and support you are providing for one another.
>
> I have a suspicion that I am not in the usual age-groups of posters, as I am 73. To summarize my life as briefly as possible, I grew up in a neglectful (mother) and abusive(alcoholic father) family. In my early twenties, I was diagnosed with anxiety, depression and borderline personality disorder. I struggled through about seven psychotherapists and psychoanalysts, with some help from almost each one, but no basic change in my illness. With the final one, however, some really wonderful changes occurred. I think that I was able to internalize him as both a better father and a better mother, and thus complete some much-needed psychosexual maturing. I was able to finish my doctoral studies, secure a university post researching, teaching, and caring for patients, marry and give birth to a son. I felt that I was living a full life and never felt the need to consult a psychiatrist again until quite recently, when I again became quite severely depressed, probably at least in part because of the inevitable losses associated with getting older. I began seeing a psychiatrist again, twice weekly, and had trials of Prozac. Paxil, Zyprexa and Wellbutrin in various combinations. All of these worked well but tended to become ineffective after several months or, in the case of the SSRIs, a few years of use.
>
> Something that I kept noticing in passing was information about how half of depressed patients have abnormally high levels of cortisol, as do,to a lesser extent, people in general as they get older. So I asked an endocrinologist to check this for me- the levels were very high, and did not suppress at all with the dexamethasone suppression test.
>
> While keeping up with my psychotherapy, which is extremely helpful, my endocrinologist and I are investigating ways to lower the circulating cortisol. Since there is not yet a CRH antagonist on the market, we are doing a number of other things in the hope of making some modest improvements in the levels. These include using tianeptine for its apparent effect(in tree shrews and rats) of protecting the limbic system from the damaging effects of high cortisol levels, taking phosphadatylserine, alpha-lipoic acid, Omega-3 fish oil, and 7-keto-dehydroepiandrosterone- all in low doses at least to begin with. Other general measures include vitamin and anti-oxidant supplements, daily walking, meditation and a massage once in a while. On a slightly different topic, we are also combining synthroid and cytomel (in a 4-1 ratio), and aiming for a TSH of below 0.5.
>
> It's too early to say whether this is going to be helpful, but it seems to be working at least as well as the previous medications. In the future, we might consider using RU-486- I expect I'll be the oldest person ever to have done so!
>
> I'm writing this because many of these ideas came from your posts, as well as from other Web-sites. I'll let you know in a while whether any of it actually worked!
>
> thanks, everyone
>
> Pfinstegg

Please do keep us apprised. I have posted on this topic, and am very interested in the neuroendocrine approach. In particular, I would be curious whether you are able to pursue mifepristone (RU-486). I am under the impression it is pretty tightly controlled.


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poster:EarlyWakening thread:119302
URL: http://www.dr-bob.org/babble/20020906/msgs/119423.html