Posted by Pfinstegg on October 15, 2005, at 22:20:02
In reply to Re: remeron and cortisol » glenn, posted by Elroy on October 14, 2005, at 21:40:58
Elroy, those cortisol results are very strong and clear-cut. Did you improve a lot clinically, as far as depression/anxiety?
Glenn (hi!), I think that if you are known not to have some kind of adrenal tumor, but still have either high levels of 24-hour cortisol, a high evening salivary cortisol, or DSM non-suppression, these things point towards HPA over-activity. If you suppress totally or partly on the DSM, I think that's supposed to mean that you have not had HPA overactivity long enough, or severely enough, to have enlarged, permanently over-active adrenal glands. That's good, but the overly high levels of 24-hour cortisol could mean you might be moving in that direction- assuming, always, that there is not another cause, like a pheochromocytoma, or one of the other rare adrenal tumors like carcinoid.
Successful TMS is associated with the return of DSM suppression and low evening salivary cortisols. The TMS is very successful for me- but only for about 6-8 weeks, when I need to return for boosters. i haven't had these values checked during my depression-free periods, but I should do it!
I'm wondering, too, why, if Remeron has such a good effect on cortisol, it doesn't have a better reputation as an AD. Maybe cortisol abnormalities are not the only or most important factors, but things we don't know as much about yet, such as glutamate and calcium channel changes, which may be equally, or more, important. I think the HPA axis plays a role in these, too, but I wish I knew much more than I do.
poster:Pfinstegg
thread:124535
URL: http://www.dr-bob.org/babble/20051010/msgs/567425.html