![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by SLS on October 1, 2005, at 13:00:49
Hi.
I am considering using dexamethasone to treat bipolar depression. Is anyone familiar with this treatment?
- Scott
-----------------------------------------------
Acta Psychiatr Scand. 1997 Jan;95(1):58-61. Related Articles, Links
Dexamethasone augmentation in treatment-resistant depression.Dinan TG, Lavelle E, Cooney J, Burnett F, Scott L, Dash A, Thakore J, Berti C.
Department of Psychological Medicine, St Bartholomew's Hospital, London, UK.
A total of 10 patients who fulfilled DSM-III-R criteria for major depression were recruited to the study, each of whom had failed to respond to a 6-week course of treatment with either sertraline or fluoxetine. Each subject had baseline serum cortisol measurements together with a Hamilton depression (HAMD) score. All patients were started on dexamethasone (3 mg daily) for 4 days, while remaining on their antidepressant treatment. Further Hamilton ratings were made on days 5 and 21. Six patients showed a significant improvement, whilst two showed a minimal response. A good clinical response was associated with a high baseline cortisol level.
PMID: 9051162 [PubMed - indexed for MEDLINE]
-------------------------------------------------------Am J Psychiatry. 1995 Feb;152(2):265-7. Related Articles, Links
Comment in:
Am J Psychiatry. 1996 Aug;153(8):1111-2; author reply 1112-3.
Am J Psychiatry. 1996 Aug;153(8):1112; author reply 1112-3.Dexamethasone for the treatment of depression: a randomized, placebo-controlled, double-blind trial.
Arana GW, Santos AB, Laraia MT, McLeod-Bryant S, Beale MD, Rames LJ, Roberts JM, Dias JK, Molloy M.
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston 29425-0742.
OBJECTIVE: The authors' goal was to assess dexamethasone for the treatment of depression. METHOD: Thirty-seven outpatients (11 men and 26 women) meeting DSM-III-R criteria for major depressive disorder were randomly assigned to receive either placebo or 4 mg/day of oral dexamethasone for 4 days. Baseline Hamilton depression scale scores were compared with scores obtained 14 days after the first dose of study medication. Data were analyzed by using two-sample t tests, chi-square methods, and Fisher's exact test. RESULTS: Seven (37%) of the 19 patients given dexamethasone but only one (6%) of the 18 patients given placebo responded positively. No adverse events or side effects were reported, and all patients who entered the study completed it. CONCLUSIONS: A brief course of oral dexamethasone (4 days) was significantly more effective than placebo within 14 days for the treatment of depression in a randomized, double-blind study of depressed outpatients.
Publication Types:
Clinical Trial
Randomized Controlled TrialPMID: 7840362 [PubMed - indexed for MEDLINE]
Posted by JaneB on October 1, 2005, at 13:41:59
In reply to Attacking the HPA axis from the other direction., posted by SLS on October 1, 2005, at 13:00:49
> Hi.
>
> I am considering using dexamethasone to treat bipolar depression. Is anyone familiar with this treatment?
>
>
> - ScottWHY?
Is your doc suggesting it?
Short term or long term?
With what other meds?
Jane
Posted by ed_uk on October 1, 2005, at 14:20:40
In reply to Attacking the HPA axis from the other direction., posted by SLS on October 1, 2005, at 13:00:49
Hi Scott,
I think it's worth a try.
1. Relatively easy to get hold of.
2. Short course of treatment.
3. You'll soon know whether or not it helps.Down side.....
Might make you feel a lot worse.... but probably only for a couple of days - until you get it 'out of your system'. Might be useful to have a Zyprexa on hand.
~Ed
Posted by Phillipa on October 1, 2005, at 14:25:27
In reply to Re: Attacking the HPA axis from the other direction. » SLS, posted by ed_uk on October 1, 2005, at 14:20:40
Hi Ed see your online. Fondly PJ O
Posted by SLS on October 1, 2005, at 17:02:51
In reply to Re: Attacking the HPA axis from the other direction., posted by JaneB on October 1, 2005, at 13:41:59
> > Hi.
> >
> > I am considering using dexamethasone to treat bipolar depression. Is anyone familiar with this treatment?
> >
> >
> > - Scott
>
> WHY?I am a dexamethasone non-suppressor. Perhaps a short course of the drug will force the system to reregulate itself so that the HPA axis functions nominally. I know it is counterintuitive, but then again, so is the mechanism behind the antidepressant tianeptine. It does exactly the opposite of the SSRIs and seems to be effective. Perhaps all that is needed it to push or pull enough to force the system to seek a new equilibrium.
> Is your doc suggesting it?
No. I came across the studies while looking for information on the use of anti-cortisol drugs in depression.
> Short term or long term?
You take the drug for only 4 days.
> With what other meds?
Everything!
:-)
Parnate 80mg
nortriptyline 100mg
Lamictal 150mg
Abilify 10mg- Scott
Posted by 4WD on October 2, 2005, at 0:23:26
In reply to Re: Attacking the HPA axis from the other direction. » JaneB, posted by SLS on October 1, 2005, at 17:02:51
?
>
> No. I came across the studies while looking for information on the use of anti-cortisol drugs in depression.
>
> > Short term or long term?
>
> You take the drug for only 4 days.
At what dosage?marsha
Posted by SLS on October 2, 2005, at 8:28:07
In reply to Re: Attacking the HPA axis from the other direction., posted by 4WD on October 2, 2005, at 0:23:26
> ?
> >
> > No. I came across the studies while looking for information on the use of anti-cortisol drugs in depression.
> >
> > > Short term or long term?
> >
> > You take the drug for only 4 days.
>
>
> At what dosage?
3-4mg
- Scott
Posted by Sarah T. on October 4, 2005, at 1:01:11
In reply to Attacking the HPA axis from the other direction., posted by SLS on October 1, 2005, at 13:00:49
Hi Scott,
I apologize for being so silly tonight, but when I first read the subject line, I automatically tried visualizing it. It was an impossible feat. I couldn't even get at the adrenals from the other end.
S.
Posted by 4WD on October 4, 2005, at 21:22:11
In reply to Re: Attacking the HPA axis from the other direction. » 4WD, posted by SLS on October 2, 2005, at 8:28:07
> > ?
> > >
> > > No. I came across the studies while looking for information on the use of anti-cortisol drugs in depression.
> > >
> > > > Short term or long term?
> > >
> > > You take the drug for only 4 days.
> >
> >
> > At what dosage?
>
>
> 3-4mg
>
>
> - Scott
>
I see my pdoc Thursday. I am taking a copy of the first study and asking him to try this.marsha
Posted by SLS on October 5, 2005, at 6:11:17
In reply to Re: Attacking the HPA axis from the other direction. » SLS, posted by 4WD on October 4, 2005, at 21:22:11
> > > > You take the drug for only 4 days.
> > > At what dosage?
> > 3-4mg
> I see my pdoc Thursday. I am taking a copy of the first study and asking him to try this.
Hi Marsha.Because I'm going away for a few weeks, I won't have the opportunity to try dexamethasone until later this month.
Please post your experiences with this. You might want to allow some time to stabilize with a consistent drug regimen before trying it.
Good luck!
- Scott
Posted by Phillipa on October 5, 2005, at 17:46:35
In reply to Re: Attacking the HPA axis from the other direction., posted by SLS on October 5, 2005, at 6:11:17
Scott, Are you going to an exotic place like the Carribean, or Hawaii? Just curious as usual. Fondly, Phillipa
Posted by 4wd on October 5, 2005, at 22:05:52
In reply to Re: Attacking the HPA axis from the other direction., posted by SLS on October 5, 2005, at 6:11:17
> > > > > You take the drug for only 4 days.
>
> > > > At what dosage?
>
> > > 3-4mg
>
> > I see my pdoc Thursday. I am taking a copy of the first study and asking him to try this.
>
>
> Hi Marsha.
>
> Because I'm going away for a few weeks, I won't have the opportunity to try dexamethasone until later this month.
>
> Please post your experiences with this. You might want to allow some time to stabilize with a consistent drug regimen before trying it.
>
> Good luck!
>
>
> - Scott
That's a good point. I've already decided no new med trials until I recuperate from this last one.Hope you are going on a long, relaxing vacation.
Marsha
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.