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Re: Remeron and Cortisol Pfinstegg

Posted by Elroy on October 16, 2005, at 18:37:29

In reply to Re: Remeron and Cortisol, posted by Pfinstegg on October 15, 2005, at 22:42:10

> Oh, OK. I jumped in and answered without reading much of the thread. Now I realize that some version of PTSD is what everyone is struggling with. Elroy, I'm assuming that you got accepted into a study at NIH because of the slim chance that you might have some kind of benign adrenal tumor?
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> These other possibilities- short courses of mefipristone or dexamethasone- would really put us at the edge of safe treatment, because we would likely need repeated courses of treatment- and side effects really do become serious there. I had to take dexamethasone for 10 days last year after lumbar disc surgery (to prevent nerve swelling), and it did have a wonderful anti-depressant effect. I was sorry to stop it, but knew I had to!
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Actually, no, my original therapist thought that I might be suffering from a form of PTSD but it has since been changed to just GAD. While I had times of higher anxiety levels, I never really had panic attacks either (once I looked into the actual definition of panic atacks, I realized I was just having time periods - anywhere from a couple hours to a full day - of higher anxiety).

Also, elevated cortisol levels (actual hypercortisolism) are frequently found in cases of depression. In fact, I'll go out on a limb here and state that probably more frequently in cases of depression than in cases of anxiety! Almost all of the testing being done with RU-486 (with the purpose of lowering cortisol while "re-setting" the HPA Axis) has so far been done with depression patients.

As to the "repeated courses" of the short-term treatments, I have no doubt that would be necessary for some treatment resistant patients, I have yet to come across study data that indicates that is a necessity for most patients treated with RU-486 anyway. In fact, there's some inference that in many patients a single short-term protocol has resulted in the re-setting of the HPA Axis which then allowed the depression (and one assumes also anxiety) to go into remission.

Obviously most of this study info is so new that follow-ups to ascertain how long the remission lasts, what follow-up protocols are necessary, etc. simply haven't come to pass yet.

Elroy


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poster:Elroy thread:124535
URL: http://www.dr-bob.org/babble/20051010/msgs/567820.html