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Re: remeron and cortisol Pfinstegg

Posted by Elroy on October 15, 2005, at 22:35:50

In reply to Re: remeron and cortisol, posted by Pfinstegg on October 15, 2005, at 22:20:02

RE: 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....


Personally, I think that is it exactly. We tend to naturally want to wrap things up into neat little compartments. If the latest med being pushed on the doc by a sales rep is an SSRI then every problem that the doc sees suddenly has to do with serotonin deficiencies. It's the old story... if the only tool you have s a hammer, then suddenly every problem starts looking like a nail.

I believe that Remeron has such a poor (fair at best) record as an AD simply because of just what you said. Many depressions and anxieties are NOT related to hypercortisol problems (heck, some depressions are caused by cortisol levels that are on the LOW side). Also, often the elevated cortisol can be as a result of the anxiety or depression and not necessarily the cause of it.

So while lowering cortisol levels would be healthy overall (as excess cortisol does a lot of nasty health things way far and beyond what it does to screw us up psychologically), the lowering of those cortisol levels - if that is the case - would likely not "cure" the anxiety and / or depression.

So, like with so many other aspects, Remeron can be the right tool for the right condition(s) at the right time. Otherwise it might be of some help (simply in lowering unhealthy cortisol levels), and in other cases, be of no help whatsoever.

Personally, I find that in situations where hypercortisolism is not a problem, that I wouldbclassify Remeron as a poor AD at nest. I found that it had some slight anti anxiety effects and that it did very little towards boosting any levels of depression.


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