Posted by myco on April 13, 2009, at 18:20:51
In reply to Re: Buspar or Celexa for extreme GAD-Bleauberry » linkadge, posted by bleauberry on April 13, 2009, at 17:08:31
What do you think about the idea that high cortisol levels are in indication of an increased probability of AD failure or non-response?
I throw in this study, even though it's somewhat "iffy" in feel with me, as a reference.
m
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J Clin Psychiatry. 1987 Dec;48(12):480-2.Pretreatment dexamethasone suppression test as a predictor of response to phenelzine.
Janicak PG, Pandey GN, Sharma R, Boshes R, Bresnahan D, Davis JM.
Illinois State Psychiatric Institute, Chicago.Twenty inpatients who met Research Diagnostic Criteria and DSM-III criteria for depression underwent a 2-week washout period before the administration of a pretreatment dexamethasone suppression test (DST); the patients then received the monoamine oxidase inhibitor (MAOI) phenelzine. The mean MAO inhibition level achieved during treatment was greater than 80%. On the basis of clinical global evaluation and changes in Hamilton Rating Scale for Depression scores, 7 of the 9 baseline DST suppressors were classified as responders, 1 as a partial responder, and 1 as a nonresponder; of the 11 baseline DST nonsuppressors, 3 were responders, 1 a partial responder, and 7 nonresponders. The Mann-Whitney U test yielded p less than .02, indicating that an abnormally high pretreatment level of cortisol in response to the DST appeared to be predictive of nonresponse to phenelzine.
--------------------------------> Yes I believe you are correct. To take it even further, I think the whole issue is more complicated than it looks. We only know a fraction of what these meds do. What I meant in general is that antidepressants tend to smooth out the peaks and valleys in cortisol curves, which is sometimes a good thing and sometimes not. And you are correct, it varies from one med to the other, and from person to person.
>
> > I don't know if I'd agree with the notion that antidepressants will decrease cortisol.
> >
> > A number of studies suggest the SSRI's (esp fluoxetine and sertraline) increase cortisol.
> >
> > The only antidepressnats that have somewhat of a documented anti-cortisol effect are remeron and doxepine / amitriptyline. Some of the antipsychotics also decrease cortisol.
> >
> > Linkadge
>
>
poster:myco
thread:890029
URL: http://www.dr-bob.org/babble/20090408/msgs/890417.html