![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by Elizabeth on May 29, 2001, at 21:35:21
Depress Anxiety 2000;12(1):44-50
Prednisone augmentation in treatment-resistant depression with fatigue and hypocortisolaemia: a case series.
Bouwer C, Claassen J, Dinan TG, Nemeroff CB.
Department of Psychological Medicine, University of Otago University, Dunedin, New Zealand. colin.bouwer@stonebow.otago.ac.nzAbnormalities of the hypothalamic-pituitary-adrenal (HPA) axis have long been implicated in major depression with hypercortisolaemia reported in typical depression and hypocortisolaemia in some studies of atypical depression. We report on the use of prednisone in treatment-resistant depressed patients with reduced plasma cortisol concentrations. Six patients with treatment-resistant major depression were found to complain of severe fatigue, consistent with major depression, atypical subtype, and to demonstrate low plasma cortisol levels. Prednisone 7.5 mg daily was added to the antidepressant regime. Five of six patients demonstrated significant improvement in depression on prednisone augmentation of antidepressant therapy. Although hypercortisolaemia has been implicated in some patients with depression, our findings suggest that hypocortisolaemia may also play a role in some subtypes of this disorder. In treatment-resistant depressed patients with fatigue and hypocortisolaemia, prednisone augmentation may be useful.
Posted by John k on May 30, 2001, at 4:44:39
In reply to glucocorticoids in depression (abstract), posted by Elizabeth on May 29, 2001, at 21:35:21
I have cortisol levels that are around 30% lower than the lower end of the normal range (at several times throughout the day--levels show a great degree of diurnal variation). I was wondering if anyone out there has the same problem (i.e., low, but not physically dangerously low as in addison's disease, levels of cortisol) and who has been relieved from fatigue, hypersensitivity to infections, etc by using low-dose glucocorticoids as an augmentation of treatment with antidepressants?
If so, did it cause adrenal suppression? Did it change the amount of antidepressant needed?
Thanks in advanceJohn
Posted by Ant-Rock on June 3, 2001, at 21:13:18
In reply to Any hypocortisolaemiacs out there?, posted by John k on May 30, 2001, at 4:44:39
> I have cortisol levels that are around 30% lower than the lower end of the normal range (at several times throughout the day--levels show a great degree of diurnal variation). I was wondering if anyone out there has the same problem (i.e., low, but not physically dangerously low as in addison's disease, levels of cortisol) and who has been relieved from fatigue, hypersensitivity to infections, etc by using low-dose glucocorticoids as an augmentation of treatment with antidepressants?
> If so, did it cause adrenal suppression? Did it change the amount of antidepressant needed?
> Thanks in advance
>
> John
Hi John,
I too had low cortisol readings, along with low-end testosterone, severe atypical depression/fatigue. The second endo-doc I saw agreed to let me try hydrocortisone therapy after I read an excellent book on the subject. Unfortunately, for me nothing dramatic happened, but this was probably due to my depression not being treated properly. Long-term Prednisone use is much more likely to cause adrenal suppression than hydrocortisone, if used in physiological doses. The case studies in the book are really fascinating.I really think this book could answer most, if not all of your questions.
If you would like, I could post the name of the book(which I can't think of right now), but the authors name is Dr. William Jeffries.
I must admit, Elizabeths post regarding the abstract: (prednisone augmentation) has got my attention.
Hope this is of some help to you and
Good Luck.
Posted by John k on June 4, 2001, at 16:04:28
In reply to Re: Any hypocortisolaemiacs out there?, posted by Ant-Rock on June 3, 2001, at 21:13:18
Thanks Ant-Rock!
It would be very nice if you could find the name of the book. I searched at amazon.com for William Jeffries, but all I got was a mystery novel and a business book! :-)
It's funny how one has to do so much treatment research on one's own, that after a while it feels like a waste that one didn't become a doctor in the first place!
John
> Hi John,
> I too had low cortisol readings, along with low-end testosterone, severe atypical depression/fatigue. The second endo-doc I saw agreed to let me try hydrocortisone therapy after I read an excellent book on the subject. Unfortunately, for me nothing dramatic happened, but this was probably due to my depression not being treated properly. Long-term Prednisone use is much more likely to cause adrenal suppression than hydrocortisone, if used in physiological doses. The case studies in the book are really fascinating.I really think this book could answer most, if not all of your questions.
> If you would like, I could post the name of the book(which I can't think of right now), but the authors name is Dr. William Jeffries.
> I must admit, Elizabeths post regarding the abstract: (prednisone augmentation) has got my attention.
> Hope this is of some help to you and
> Good Luck.
Posted by Dr. Bob on June 4, 2001, at 20:59:13
In reply to Re: Any hypocortisolaemiacs out there?, posted by Ant-Rock on June 3, 2001, at 21:13:18
> I too had low cortisol readings, along with low-end testosterone, severe atypical depression/fatigue...
Hey, welcome back, long time no post, right?
Bob
Posted by Ant-Rock on June 4, 2001, at 21:24:11
In reply to Re: welcome back » Ant-Rock, posted by Dr. Bob on June 4, 2001, at 20:59:13
> > I too had low cortisol readings, along with low-end testosterone, severe atypical depression/fatigue...
>
> Hey, welcome back, long time no post, right?
>
> Bob
Thanks for the greeting, Dr. Bob.
Haven't posted in a while, but frequently lurk.
Posted by vince on June 4, 2001, at 23:01:46
In reply to Re: Any hypocortisolaemiacs out there?, posted by Ant-Rock on June 3, 2001, at 21:13:18
> > I have cortisol levels that are around 30% lower than the lower end of the normal range (at several times throughout the day--levels show a great degree of diurnal variation). I was wondering if anyone out there has the same problem (i.e., low, but not physically dangerously low as in addison's disease, levels of cortisol) and who has been relieved from fatigue, hypersensitivity to infections, etc by using low-dose glucocorticoids as an augmentation of treatment with antidepressants?
> > If so, did it cause adrenal suppression? Did it change the amount of antidepressant needed?
> > Thanks in advance
> >
> > John
> Hi John,
> I too had low cortisol readings, along with low-end testosterone, severe atypical depression/fatigue. The second endo-doc I saw agreed to let me try hydrocortisone therapy after I read an excellent book on the subject. Unfortunately, for me nothing dramatic happened, but this was probably due to my depression not being treated properly. Long-term Prednisone use is much more likely to cause adrenal suppression than hydrocortisone, if used in physiological doses. The case studies in the book are really fascinating.I really think this book could answer most, if not all of your questions.
> If you would like, I could post the name of the book(which I can't think of right now), but the authors name is Dr. William Jeffries.
> I must admit, Elizabeths post regarding the abstract: (prednisone augmentation) has got my attention.
> Hope this is of some help to you and
> Good Luck.
I for one would be interested in the name of the book that you mention above.I'm curious, you say that you had low testosterone levels also. Did you try testosterone replacement?
I tested low for total testosterone but I don't think that is the cause of my depression because I have had depression since I was twenty-two years old and I'm sure that at that age I didn't have low testosterone levels. At least it didn't feel like it.
I wish that I would have had my cortisol levels tested at the same time but I didn't.
Vince
Posted by shelliR on June 5, 2001, at 10:46:34
In reply to Re: welcome back, posted by Ant-Rock on June 4, 2001, at 21:24:11
> > > I too had low cortisol readings, along with low-end testosterone, severe atypical depression/fatigue...
> >
> > Hey, welcome back, long time no post, right?
> >
> > Bob
> Thanks for the greeting, Dr. Bob.
> Haven't posted in a while, but frequently lurk.Anthony,
Just saw your post and the greeting back by Dr. Bob. In thinking about the subject of an old-timers board, I've been sort of reviewing my experience on PB in the last year. I think this is about a year for me, maybe a year and a few months. You were one of only like three people (SLS was another) who reponded to me (my posts) and who I communicated with when I first came to this board. I am still grateful. I am glad you posted because it reminded me, and I hope you are doing well, or at least better?Shelli
Posted by Ant-Rock on June 6, 2001, at 14:22:26
In reply to Re: Any hypocortisolaemiacs out there?, posted by John k on June 4, 2001, at 16:04:28
> Thanks Ant-Rock!
>
> It would be very nice if you could find the name of the book. I searched at amazon.com for William Jeffries, but all I got was a mystery novel and a business book! :-)
>
> It's funny how one has to do so much treatment research on one's own, that after a while it feels like a waste that one didn't become a doctor in the first place!
>
> John
>
John,
"Safe Uses of Cortisol", by William Jefferies, is the name of the book. Althogh not much regarding depression in it, very informative, and a must read if one has tested low for cortisol. Book was well worth it and I highly reccomend it. Please let me know how you make out.Anthony
Posted by Ant-Rock on June 6, 2001, at 14:40:42
In reply to Re: Any hypocortisolaemiacs out there? » Ant-Rock, posted by vince on June 4, 2001, at 23:01:46
>
>
> I for one would be interested in the name of the book that you mention above.
>
> I'm curious, you say that you had low testosterone levels also. Did you try testosterone replacement?
>
> I tested low for total testosterone but I don't think that is the cause of my depression because I have had depression since I was twenty-two years old and I'm sure that at that age I didn't have low testosterone levels. At least it didn't feel like it.
>
> I wish that I would have had my cortisol levels tested at the same time but I didn't.
>
> VinceVince,
"Safe Uses of Cortisol", by William Jefferies,
is the name of this excellent book.
I never tried testosterone replacement, but the new gell (Androderm, I think is the name)would make this any easy option to consider. My endo-Doc prescribed me "Clomid", which is a fertility drug for women, that helps your body increase its testosterone output. My levels were brought up, but unfortunately I didn't experience the outcome I was hoping for, ie. return of sex drive/libido, increased energy, etc.
I guess until I get this depression conquered, it doesn't matter how I try to treat my physical symptoms, nothing will change.
Good luck Vince, and please keep posting your results.Anthony
Posted by Ant-Rock on June 6, 2001, at 15:08:41
In reply to Re: welcome back, posted by shelliR on June 5, 2001, at 10:46:34
> > > > I too had low cortisol readings, along with low-end testosterone, severe atypical depression/fatigue...
> > >
> > > Hey, welcome back, long time no post, right?
> > >
> > > Bob
> > Thanks for the greeting, Dr. Bob.
> > Haven't posted in a while, but frequently lurk.
>
> Anthony,
> Just saw your post and the greeting back by Dr. Bob. In thinking about the subject of an old-timers board, I've been sort of reviewing my experience on PB in the last year. I think this is about a year for me, maybe a year and a few months. You were one of only like three people (SLS was another) who reponded to me (my posts) and who I communicated with when I first came to this board. I am still grateful. I am glad you posted because it reminded me, and I hope you are doing well, or at least better?
>
> Shelli
Hi Shellie,
It's nice to hear from you again. I think the old-timers board is a great idea. I too am greatful for Dr.Bob and this board. Unfortunately, this year so far has been pure hell. I'm trying to get through a very unexpected and painful divorce, which has gotten complicated and emotionally draining. I must say though, when this first happenned at the beginning of the year, I asked for help and advice on the psycho-social board, and a few very thoughtful, wonderful people gave me support/advice and made me realize that I shouldn't be blaming myself. As It turned out, I certainly was falsely blaming myself.
Anyway, I hope you are well. are you still running your own business? Photography, if I remember correctly.Anthony
P.S. ( Dr. Bob, sorry for the social rambling on this board, but I did want to relate to you my gratitude for these forums, during a very trying time.)
Posted by vince on June 6, 2001, at 18:03:42
In reply to Re: Any hypocortisolaemiacs out there? » vince, posted by Ant-Rock on June 6, 2001, at 14:40:42
> Vince,
>
> "Safe Uses of Cortisol", by William Jefferies,
> is the name of this excellent book.
> I never tried testosterone replacement, but the new gell (Androderm, I think is the name)would make this any easy option to consider. My endo-Doc prescribed me "Clomid", which is a fertility drug for women, that helps your body increase its testosterone output. My levels were brought up, but unfortunately I didn't experience the outcome I was hoping for, ie. return of sex drive/libido, increased energy, etc.
> I guess until I get this depression conquered, it doesn't matter how I try to treat my physical symptoms, nothing will change.
> Good luck Vince, and please keep posting your results.
>
> AnthonyAnthony, Thanks for the the name of the book. I tried Clomid but it made the depression even worse. I'm wondering if I can get my doc to prescribe HCG it's supposed to be even better at stimulating test production but doesn't affect estrogen levels as much. I think that's what worsens mood. I don't really want to try testosterone replacement unless I have to since that can curtail natural production.
Vince
Posted by Ant-Rock on June 6, 2001, at 20:18:15
In reply to Re: Any hypocortisolaemiacs out there?, posted by vince on June 6, 2001, at 18:03:42
> > Vince,
> >
> > "Safe Uses of Cortisol", by William Jefferies,
> > is the name of this excellent book.
> > I never tried testosterone replacement, but the new gell (Androderm, I think is the name)would make this any easy option to consider. My endo-Doc prescribed me "Clomid", which is a fertility drug for women, that helps your body increase its testosterone output. My levels were brought up, but unfortunately I didn't experience the outcome I was hoping for, ie. return of sex drive/libido, increased energy, etc.
> > I guess until I get this depression conquered, it doesn't matter how I try to treat my physical symptoms, nothing will change.
> > Good luck Vince, and please keep posting your results.
> >
> > Anthony
>
>
>
> Anthony, Thanks for the the name of the book. I tried Clomid but it made the depression even worse. I'm wondering if I can get my doc to prescribe HCG it's supposed to be even better at stimulating test production but doesn't affect estrogen levels as much. I think that's what worsens mood. I don't really want to try testosterone replacement unless I have to since that can curtail natural production.
>
> VinceVince,
What is HCG ?
Posted by vince on June 7, 2001, at 0:33:27
In reply to Re: Any hypocortisolaemiacs out there? » vince, posted by Ant-Rock on June 6, 2001, at 20:18:15
> > > Vince,
> > >
> > > "Safe Uses of Cortisol", by William Jefferies,
> > > is the name of this excellent book.
> > > I never tried testosterone replacement, but the new gell (Androderm, I think is the name)would make this any easy option to consider. My endo-Doc prescribed me "Clomid", which is a fertility drug for women, that helps your body increase its testosterone output. My levels were brought up, but unfortunately I didn't experience the outcome I was hoping for, ie. return of sex drive/libido, increased energy, etc.
> > > I guess until I get this depression conquered, it doesn't matter how I try to treat my physical symptoms, nothing will change.
> > > Good luck Vince, and please keep posting your results.
> > >
> > > Anthony
> >
> >
> >
> > Anthony, Thanks for the the name of the book. I tried Clomid but it made the depression even worse. I'm wondering if I can get my doc to prescribe HCG it's supposed to be even better at stimulating test production but doesn't affect estrogen levels as much. I think that's what worsens mood. I don't really want to try testosterone replacement unless I have to since that can curtail natural production.
> >
> > Vince
>
> Vince,
> What is HCG ?
Human Chorionic Gonadotropin - extracted from the urin of pregnant women. Like clomid it is a fertility drug.Vince
Posted by John k on June 7, 2001, at 5:08:05
In reply to Re: Any hypocortisolaemiacs out there? » John k, posted by Ant-Rock on June 6, 2001, at 14:22:26
Thanks a lot! It seems like just the kind of info I need.
John
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.