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remeron and cortisol

Posted by glenn on October 21, 2002, at 14:42:04

Remeron , cortisol and the hpa axis.

I have my doubts about remeron as an effective anti cortisol med, I may be wrong but consider the following:

I know I have very high cortisol levels both from urinary and salivary tests yet Remeron did nothing for me.
It was very tolerable and good for sleep but did not affect my mood at all. ( 3 months)

In theory remeron sounds like an almost ideal medication, it affects both serotonin and noradrenaline and it seems lowers cortisol. It sounds like a mixture of celexa, reboxetine and anticort yet it has a pretty miserable reputation as an anti depressant, most of the reports I have seen suggest it as good for sleep and non sexually dysfunctionalising but certainly no more effective than any other ssri / ssnri.

As opposed to RU 486 and holy basil it does not have a reputation for acting particularly quickly which would be surprising if it were that active against cortisol as both the aforementioned substances are.

However I may be totally wrong here and maybe I have missed something, so please feel free to put me straight.

This bit is mainly for pfinstegg. I am not sure about something you said in your response to NikkiT2.
If I got this right you were explaining that successful dexamethasone suppression indicates that the hpa axis is working ok. I am not sure about this for a number of reasons:

Firstly the test is I believe to distinguish between a tumor caused increase in cortisol and “ other causes”
If the dexamethasone fails it is because it’s anti cortisol action does not affect tumor-produced cortisol.
Whilst it clearly can cause cortisol suppression if there is no tumor, I am not sure that this indicates that the hpa axis is working ok. In my case for example dexamethasone causes a temporary drop in cortisol but it goes back after the 24 hours.

Secondly if the hpa axis is ok (as evidenced by the dexamethasone working) how do the cortisol levels get so high in the first place and stay that way. I know stress is the original cause but if one was still ok hpa axis wise, cortisol levels should eventually return to within the norm on their own without dexamethasone suppression.

I am not too sure about all of this and its making my poor brain hurt trying to express it so ill stop now and maybe you could let me know your thoughts.





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