![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by JasonL on February 12, 2001, at 20:35:59
Has anyone on this board specifiaclly worked to lower
cortisol levels with drugs like ketaconozole or procaine HCI (soon to be Anti-cort)for depression/anxiety. I've read a lot of studies lately. Results seemed to be mixed and dependent on basil cortisol levels in patients. My own cortisol levels are high and I have been treatment resistent thus far.JasonL
Posted by Bill L on February 14, 2001, at 7:27:12
In reply to Targeting cortisol for depression?, posted by JasonL on February 12, 2001, at 20:35:59
I personally have not heard of using a cortisol lowering drug to fight anxiety or depression but that does sound interesting. I have thought of elevated cortisol being an effect of anxiety. But I never thought of it as being a cause.
Do you have very high cortisol levels? If so, have you been checked to rule out medical problems affecting the gland that makes cortisol? I think it's the adrenal gland but I'm not sure.
Do you have anxiety or depression? If so ,what meds have you tried?
> Has anyone on this board specifiaclly worked to lower
> cortisol levels with drugs like ketaconozole or procaine HCI (soon to be Anti-cort)for depression/anxiety. I've read a lot of studies lately. Results seemed to be mixed and dependent on basil cortisol levels in patients. My own cortisol levels are high and I have been treatment resistent thus far.
>
> JasonL
Posted by Bill L on February 14, 2001, at 12:46:11
In reply to Re: Targeting cortisol for depression?, posted by Bill L on February 14, 2001, at 7:27:12
After I responded to your post, I saw this post on a different board so here it is:
---------------------------------------
No, they lower cortisol levels. One of the things SSRIs do is improve
the cortisol situation in depressives. Im not familiar with all the
technical specifics of how and why they do that, but chronic usage of
SSRIs definitely insulates you to a degree from the harmful effects of
excess cortisol. I am pretty sure that longterm use of SSRIs actually
cuts down on cortisol output in depressives, however I am not 100% sure.
There is a whole new futuristic class of antidepressants in the
research and development stage that works on the cortisol theory of
depression. Called "CRF-Antagonists" they are said to work much faster
than any of the current classes of antidepressants. Instead of taking a
month or more to kick in, CRF-Antagonists are predicted to kick in
within a day or two. We will see whether this really pans out to be
true or whether they will work or not.
CRF-Antagonists are still in beginning to intermediate stages of R&D.
Id say it will be another ten years before these new antidepressants
actually get FDA approved and are at the drugstore...if they ever even
make it that far of course.> I personally have not heard of using a cortisol lowering drug to fight anxiety or depression but that does sound interesting. I have thought of elevated cortisol being an effect of anxiety. But I never thought of it as being a cause.
>
> Do you have very high cortisol levels? If so, have you been checked to rule out medical problems affecting the gland that makes cortisol? I think it's the adrenal gland but I'm not sure.
>
> Do you have anxiety or depression? If so ,what meds have you tried?
>
> > Has anyone on this board specifiaclly worked to lower
> > cortisol levels with drugs like ketaconozole or procaine HCI (soon to be Anti-cort)for depression/anxiety. I've read a lot of studies lately. Results seemed to be mixed and dependent on basil cortisol levels in patients. My own cortisol levels are high and I have been treatment resistent thus far.
> >
> > JasonL
Posted by SLS on February 14, 2001, at 15:11:41
In reply to Targeting cortisol for depression?, posted by JasonL on February 12, 2001, at 20:35:59
Hi.
I know that ketaconozole has been tried in cases of treatment-resistant depression, and also chronic fatigue syndrome. I can't comment about its efficacy, as I have not followed up on it.
I also have elevated cortisol levels and tested positive on the old DST (Dethamexasone Suppression Test), a test to see if the negative feedback loop limiting cortisol production by the adrenal cortex is working properly. I am also treatment resistant. Have you tried a tricyclic?
- Scott> Has anyone on this board specifiaclly worked to lower
> cortisol levels with drugs like ketaconozole or procaine HCI (soon to be Anti-cort)for depression/anxiety. I've read a lot of studies lately. Results seemed to be mixed and dependent on basil cortisol levels in patients. My own cortisol levels are high and I have been treatment resistent thus far.
>
> JasonL
Posted by MarkinBoston on February 15, 2001, at 11:55:09
In reply to Targeting cortisol for depression?, posted by JasonL on February 12, 2001, at 20:35:59
I looked down this path and found studies published in PNAS last year by the NIH on CRF antagonists. Those drugs are not available yet, and most current drugs that are enough to wipe out cortisol will take your sex hormones away too!
Ketaconozole is one that will turn you into a unich. Its an anti-fungal that very closely resembles steroidal hormones, and like most anti-fungals, damages your liver.
My cortisol and estradiol measured high and testosterone low at the fringes of "normal", but in the least desireable combo. I'm sure this is pretty common and the interrelation makes sense. One other thing is that high estradiol levels amplify CRF response to stress, so managing that could be considered. Its easy to do, risky to overdo, and I have yet to find a Dr. that could understand why it was important to me to get my estradiol down to a median value and give me a script. Don't try this without blood work.
I decided that treating high cortisol as a symptom would be nice until an AD kicked in, but was a lot of hassle and compromise. An AD is the right way to fix the HPA axis and get cortisol down.
High cortisol is bad for long term health. All those studies and suggestions on cutting stress are about cutting cortisol. Its important to treat the depression for this alone.
I picture a huge market for these future CRF antagonists as anti-stress pills for everyone, not limited to the depressed.
> Has anyone on this board specifiaclly worked to lower
> cortisol levels with drugs like ketaconozole or procaine HCI (soon to be Anti-cort)for depression/anxiety. I've read a lot of studies lately. Results seemed to be mixed and dependent on basil cortisol levels in patients. My own cortisol levels are high and I have been treatment resistent thus far.
>
> JasonL
Posted by JasonL on February 15, 2001, at 18:21:37
In reply to Re: Targeting cortisol for depression?, posted by SLS on February 14, 2001, at 15:11:41
> Scott,
I have a brief stint on Anafrinil for a about 3 days before I found the side effects intolerable. I'm on Paxil right now. I was just reading some posts about imiprimine...is this a tricyclic? I'm running out of hope and options. I'm extremely suicidal during the days, though I notice a decided lessoning of the depression as the evening comes. I spend most of my days in bed just trying to breathe the pain away, asking God to just take me in my sleep. Its an aweful existence. I wondered if I could get my cortisol levels down if this could help take some of the pain away that I go through during the daylight hours...when my levels are well above the normal range. As midnight approaches, the cortisol levels drop back to normal levels...and this why I suspect I don't have insomnia as many people who are severely depressed do.
Curious, Scott, has anything helped you with depression? What has kept you going?
JasonL
>
Posted by JasonL on February 15, 2001, at 18:27:11
In reply to Re: Targeting cortisol for depression? » JasonL, posted by MarkinBoston on February 15, 2001, at 11:55:09
>
Mark,Thanks for your insight. I think I will try the ketoconozole when it arrives. I have to check around, but I think ketoconozole inhipits the p450 enzyme which Paxil also does too. This could be a problem. I have yet to find an anti-depressent to pull me out of a severe depression that has lasted for years.
What AD is helping you right now?
JasonL
Posted by SLS on February 15, 2001, at 20:59:24
In reply to Re: Targeting cortisol for depression? Scott, posted by JasonL on February 15, 2001, at 18:21:37
Dear Jason,
It sounds to me like you have a melancholic, classical unipolar depression that tends to respond well to tricyclic antidepressants like imipramine and Anafranil. Anafranil sucks. It is probably the worst of the tricyclics in terms of side effects, although it is probably the most efficacious. Imipramine has been the "gold standard" against which other antidepressants are compared. If you are particularly sensitive to the side effects of tricyclics in general, desipramine and nortriptyline would make good choices as their side effects are relatively mild. I encourage you to try either imipramine, desipramine, or nortriptyline and start at a low dosage and increase the dosage gradually. Startup side effects often lessen with time, so the key is to minimize them early with low dosages so that you can move up more comfortably. I believe days 3-5 are the worst. See if you can get through them.
I tend to agree with Mark regarding the treatment of cortisol activity.
Keep going. You'll get there. But you gotta' be in it to win it. Easier said than done - I know.
Sincerely,
Scott> > Scott,
>
> I have a brief stint on Anafrinil for a about 3 days before I found the side effects intolerable. I'm on Paxil right now. I was just reading some posts about imiprimine...is this a tricyclic? I'm running out of hope and options. I'm extremely suicidal during the days, though I notice a decided lessoning of the depression as the evening comes. I spend most of my days in bed just trying to breathe the pain away, asking God to just take me in my sleep. Its an aweful existence. I wondered if I could get my cortisol levels down if this could help take some of the pain away that I go through during the daylight hours...when my levels are well above the normal range. As midnight approaches, the cortisol levels drop back to normal levels...and this why I suspect I don't have insomnia as many people who are severely depressed do.
>
> Curious, Scott, has anything helped you with depression? What has kept you going?
>
> JasonL
> >
Posted by MarkinBoston on February 16, 2001, at 0:22:27
In reply to Re: Targeting cortisol for depression? Mark, posted by JasonL on February 15, 2001, at 18:27:11
I'm taking 225-300mg/day of non-XR Effexor and 20-40 mg of Adderall/day. I think my AM cortisol was about 18 or 19 and estradiol 50. Besides cortisol, testosterone and estradiol share the same diurnal profile. Ketoconazole will wipe them all out and should have you feeling less miserable and functional enough to get on another AD. Previously, I have tried Nortryptaline with Effexor. The side effects were not too bad, but I stopped taking it because it didn't seem to add to what Effexor was doing.
Did you do a Dexamethasone suppression test? The wierd thing is that I felt fantastic the day after taking 1 mg. Anyone else? Dex isn't a long term option, unfortunately.
> Mark,
>
> Thanks for your insight. I think I will try the ketoconozole when it arrives. I have to check around, but I think ketoconozole inhipits the p450 enzyme which Paxil also does too. This could be a problem. I have yet to find an anti-depressent to pull me out of a severe depression that has lasted for years.
>
> What AD is helping you right now?
>
> JasonL
Posted by vince on February 16, 2001, at 13:45:52
In reply to Re: Targeting cortisol for depression? Scott, posted by JasonL on February 15, 2001, at 18:21:37
> > Scott,
>
> I have a brief stint on Anafrinil for a about 3 days before I found the side effects intolerable. I'm on Paxil right now. I was just reading some posts about imiprimine...is this a tricyclic? I'm running out of hope and options. I'm extremely suicidal during the days, though I notice a decided lessoning of the depression as the evening comes. I spend most of my days in bed just trying to breathe the pain away, asking God to just take me in my sleep. Its an aweful existence. I wondered if I could get my cortisol levels down if this could help take some of the pain away that I go through during the daylight hours...when my levels are well above the normal range. As midnight approaches, the cortisol levels drop back to normal levels...and this why I suspect I don't have insomnia as many people who are severely depressed do.
>
> Curious, Scott, has anything helped you with depression? What has kept you going?
>
> JasonL
> >Scott,
I know exactly how you feel. I almost cried for you when I read your post. Nobody can know what another person suffers. Nobody can know what I have been through the past six months. I've been on my knees continually asking God to take me. I do not want to take my own life. If depression teaches a religious person anything it is a profound fear of hell - just to know such a state can exist is enough. What drives my suicidal ideation is not the sadness, nor the feelings of guilt, or worthlessness, but just this inexplicable psychological pain that keeps coming in wave upon overwhelming wave. But as you say it does seem to subside somewhat in the evening.
I tried some over-the-counter cortical blocking things like CortBlock that seemed to help a little then wore off after a couple of hours and would leave me with a blah kind of feeling, like a caffeine let down.
In late December I asked my doctor to try me on Neurontin and Zoloft. Neurontin as an experiment and Zoloft for some obsessive thinking that was bothering me a lot and because Zoloft was the only SSRI that I hadn't tried. I had a terrible reaction to the Zoloft. I became extremely agitated and even more depressed, completely immobilized. I had to give it up.
I stayed with the Neurontin though. I'm at 1800 mg per day. It got rid of the psychological pain that I described above, the suicidal thoughts, and the obsessive thinking. It’s better than any SSRI that I have used. Neurontin is kind of a hit and miss thing it works great for some and doesn’t do anything for others. If you want to find out more about it then go to: http://psycom.net/depression.central.gabapentin.html
I had planned on trying adrafanil and amisulpride because I had read about it on this board. I have even sent for these overseas. I have received the amisulpride but not the adrafanil. But right now I’m getting good results from the Neurontin so I don’t want to do too many things at one time.
Well good luck to you and God bless you in finding something that will relieve your suffering.
Vince
Posted by Noa on February 17, 2001, at 11:54:48
In reply to Re: Targeting cortisol for depression? Mark, posted by JasonL on February 15, 2001, at 18:27:11
Jason, have you been checked for adrenal/pituitary related disorders, like Cushings?
Posted by mocdoc on May 30, 2001, at 14:13:27
In reply to Targeting cortisol for depression?, posted by JasonL on February 12, 2001, at 20:35:59
xxx
Above URL should bring you to a preliminary study of ketoconazole in depression-it is said to help those depressives who have elevated cortisol, but not other depressives. Very preliminary study. Also, ketoconazole is not the safest of drugs.
mocdoc
Posted by Lorraine on May 31, 2001, at 9:27:36
In reply to Re: Targeting cortisol for depression?, posted by mocdoc on May 30, 2001, at 14:13:27
You can order a saliva test of your cortisol and dhea levels for about $60 from http://www.bodybalance.com/
Posted by Lorraine on May 31, 2001, at 11:55:55
In reply to Re: Targeting cortisol for depression?, posted by Lorraine on May 31, 2001, at 9:27:36
This is from The Diet Cure by Julia Ross M.A. (this is a good book).
For over production of corisol she recommends the following supplements:
B1 200 mg 3x day
DHEA 5-10 mg females (males 10-15 mg)
Phosphorylated serine
Vitamin CLef.org has info on natural sources to control cortisol production also. Unfortunately, they lump cortisol enhancing and cortisol decreasing strategies together. Among those for lower cortisol are the following:
Vitamin C (at least 4 grams)
Aspirin (1/4 size)
DHEA
Double doses of the procaine formulas KH3 or GH3 (The Life Extension Foundation does not carry KH3, but can provide a list of companies abroad that sell KH3 to Americans for personal use)Hope this helps
Posted by JonB on June 1, 2001, at 11:44:52
In reply to Re: Targeting cortisol for depression?, posted by Bill L on February 14, 2001, at 7:27:12
I haven't been tested but I seem to have all of the symptoms of high cortisol. For some further background on this I recommend reading about this new CRF antagonist being developed by Neurocrine at;
http://www.neurocrine.com/clinical/clinical_anxiety.html
Another interesting article on how this problem develops can be found at;
http://psychiatry.medscape.com/Medscape/psychiatry/TreatmentUpdate/2000/tu03/public/toc-tu03.html
Specifically the section on "Neurobiological Alterations That Result From Early Life Trauma".
I understand what you all are saying here and have learned that I need to ensure that I never allow stress to knock me over the edge and get my cortisol going. This has caused some neurotic adaptations to develop over the years but in recent years I've had several frightening "run-in's" with stressors that have resulted in my developing several bouts of major depression. Trying some interesting meds like SAM-e, Serzone, St John's Wort and Neurotin in various combinatio
Posted by Lorraine on June 1, 2001, at 16:58:56
In reply to Re: Targeting cortisol for depression?, posted by JonB on June 1, 2001, at 11:44:52
Thanx for the cites and sites. Great info.
Posted by laurai01 on June 25, 2001, at 9:55:47
In reply to Re: Targeting cortisol for depression? Scott » JasonL, posted by vince on February 16, 2001, at 13:45:52
> > > Scott,
> >
> > I have a brief stint on Anafrinil for a about 3 days before I found the side effects intolerable. I'm on Paxil right now. I was just reading some posts about imiprimine...is this a tricyclic? I'm running out of hope and options. I'm extremely suicidal during the days, though I notice a decided lessoning of the depression as the evening comes. I spend most of my days in bed just trying to breathe the pain away, asking God to just take me in my sleep. Its an aweful existence. I wondered if I could get my cortisol levels down if this could help take some of the pain away that I go through during the daylight hours...when my levels are well above the normal range. As midnight approaches, the cortisol levels drop back to normal levels...and this why I suspect I don't have insomnia as many people who are severely depressed do.
> >
> > Curious, Scott, has anything helped you with depression? What has kept you going?
> >
> > JasonL
> > >
>
> Scott,
>
> I know exactly how you feel. I almost cried for you when I read your post. Nobody can know what another person suffers. Nobody can know what I have been through the past six months. I've been on my knees continually asking God to take me. I do not want to take my own life. If depression teaches a religious person anything it is a profound fear of hell - just to know such a state can exist is enough. What drives my suicidal ideation is not the sadness, nor the feelings of guilt, or worthlessness, but just this inexplicable psychological pain that keeps coming in wave upon overwhelming wave. But as you say it does seem to subside somewhat in the evening.
>
> I tried some over-the-counter cortical blocking things like CortBlock that seemed to help a little then wore off after a couple of hours and would leave me with a blah kind of feeling, like a caffeine let down.
>
> In late December I asked my doctor to try me on Neurontin and Zoloft. Neurontin as an experiment and Zoloft for some obsessive thinking that was bothering me a lot and because Zoloft was the only SSRI that I hadn't tried. I had a terrible reaction to the Zoloft. I became extremely agitated and even more depressed, completely immobilized. I had to give it up.
>
> I stayed with the Neurontin though. I'm at 1800 mg per day. It got rid of the psychological pain that I described above, the suicidal thoughts, and the obsessive thinking. It’s better than any SSRI that I have used. Neurontin is kind of a hit and miss thing it works great for some and doesn’t do anything for others. If you want to find out more about it then go to: http://psycom.net/depression.central.gabapentin.html
>
> I had planned on trying adrafanil and amisulpride because I had read about it on this board. I have even sent for these overseas. I have received the amisulpride but not the adrafanil. But right now I’m getting good results from the Neurontin so I don’t want to do too many things at one time.
>
> Well good luck to you and God bless you in finding something that will relieve your suffering.
>
> VinceGuys,
Last fall I was so depressed that I could only
get out of bed if I had a friend call me in the morning and talk to me for a
few minutes. Last month I started taking Elavil for the insomnia.
In exactly two weeks the antidepressant effects
kicked in. It was amazing. I'm am still depressed
and unemployed, but I am purposely trying to stop
my depressive, defeated thoughts and
focus on better, happier things; I am trying to
change my brain chemistry.The elavil worked for me. I'm only taking 75mg/day.
I know it has side effects, but for the moment, it
is better than the depression.I'm sorry to hear that you are in such pain. But please
keep trying, keep getting out of bed. I believe
I am getting better.laura
Posted by mocdoc on June 25, 2001, at 18:10:06
In reply to Re: Targeting cortisol for depression? Scott, posted by laurai01 on June 25, 2001, at 9:55:47
Dear Vince'
I had the same reaction as you did-extreme agitation on a very low dose of Zoloft-12.5 mg/day! I guess most patients take 50mg/day.I had to stop it after 3 days-I was jumping out of my skin and could not stop pacing. Akathesia?! My doctor next tried me on Neurontin and after only 600 mg daily, I was completely zonked, obtunded, out of it, unable to think, mentally paralyzed. gorked..................So I raised my clonazepin to 2mg a day(1 mg every 12 hours) from 1mg a day (my prescription gives me that option) and at least I'm back to merely being depressed and obsessed. I have bipolar II+OCD. With my doctor's approval, I have ordered tianeptine from overseas as I react paradoxically to all serotonin reuptake inhibitors, specific or otherwise, with worsening of my OCD and no help for depression.Tianeptine paradoxically does the opposite of serotonin reuptake inhibitors yet it's a viable antidepressant,used in many countries.. Oh well, one must be philosophical-I had my best year in 46 years from April 2000 to April 2001.I'm thankful for that.
Be well everyone,
mocdoc
Posted by essbee on January 8, 2004, at 10:34:40
In reply to Re: Targeting cortisol for depression? » JasonL, posted by MarkinBoston on February 15, 2001, at 11:55:09
Is it not possible to lower cortisol levels through magnesium supplement?
I have read several articles on the internet that this would be the case./essbee
Posted by essbee on January 8, 2004, at 10:40:49
In reply to Re: Natural remedies for reducing cortisol, posted by Lorraine on May 31, 2001, at 11:55:55
I would not recommend DHEA for reducing cortisol. DHEA will be used to produce more cortisol.
/essbee
Posted by Dr. Bob on January 8, 2004, at 17:27:32
In reply to lower cortisol levels through magnesium supplement, posted by essbee on January 8, 2004, at 10:34:40
> Is it not possible to lower cortisol levels through magnesium supplement? ...
I'd like to redirect this thread to Psycho-Babble Alternative. Here's a link:
http://www.dr-bob.org/babble/alter/20031218/msgs/298261.html
Thanks,
Bob
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.