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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Janmar on August 5, 2003, at 3:36:02
My brain feels impaired. I have no creativity- I can't have much conversation because no thoughts come to me. I can't seem to focus on anything because my thoughts are scattered. My usually good discipline with my kids has gone down the drain, and I don't feel like I connect with them emotionally. Actually it's my discipline with myself that's gone. I don't feel like eating during the day, but I'll eat tons of junk at night and I keep staying up later and later. I feel the worst when I have to get up. I've had these feelings/symptoms before. I have deep sadness inside, but I can't cry. I am numb to emotions except fear. Also way more sweating and oily face. I've been reading web sites about the effect of cortisol on the brain, and I think I might not have depression, but the effects of continual anxiety-producing stress on my brain for the last 6 months.
I don't know how to explain it without sounding like a big complainer.
I've been on Paxil, Zoloft, Welbutrin, Celexa, Lexapro, Prozac, none has ever seemed to do anything. The thing that made me feel sort of normal was Ritalin. But that has lost its effectiveness now.
Is there a drug that lowers cortisol and its effects?
Thanks
Posted by SLS on August 5, 2003, at 8:15:54
In reply to Cortisol , posted by Janmar on August 5, 2003, at 3:36:02
> I've been on Paxil, Zoloft, Welbutrin, Celexa, Lexapro, Prozac, none has ever seemed to do anything. The thing that made me feel sort of normal was Ritalin. But that has lost its effectiveness now.
> Is there a drug that lowers cortisol and its effects?There are two that come to mind, however, I think you should concentrate more on treating the depression, and let the antidepressants do the work on the cortisol.
1. ketaconozole
2. mifepristone (RU-486)I think you should try Effexor first before moving on to other antidepressants. Have you tried a tricyclic antidepressant or an MAOI (monoamine oxidase inhibitor) like Parnate or Nardil?
- Scott
Posted by Anonne on August 7, 2003, at 0:40:44
In reply to Re: Cortisol , posted by SLS on August 5, 2003, at 8:15:54
Hi. Wondered what tests (blood and urine) were good to test cortisol levels, esp. for those who have lived with ongoing depression (sometimes in partial remission) for years?
My current psychiatrist said she was not getting much information in that area from the psychiatric 'community'. This came up because I asked for the names of the specific tests for measuring said levels of cortisol. Tests that would work w/ the HPA axis. She agreed that dexamethazone suppression tests are pretty much out of favor (they used to be widely used, at least in the '80s).
Anyone have any ideas?
Tx.
Posted by BekkaH on August 7, 2003, at 20:15:42
In reply to What tests are recommended to check CORTISOL level, posted by Anonne on August 7, 2003, at 0:40:44
Hi. I think it would be helpful for you to consult with an endocrinologist. I'm surprised that your psychiatrist said that she is not getting information from the psychiatric community on this topic. Cortisol and HPA axis (hypothalamic-pituitary-adrenal axis) dysregulation are among the most important issues in biopsychiatry and psycho-neuroendocrinology today. There are many tests for HPA axis dysfunction; to mention just a few, there are tests for plasma cortisol, 24-hour urinary free cortisol, urinary 17-ketosteroids, urinary 17-hydroxycorticosteroids, ACTH stimulation tests, and others.
Posted by Anonne on August 7, 2003, at 23:38:10
In reply to tests to check CORTISOL levels - Anonne, posted by BekkaH on August 7, 2003, at 20:15:42
Thanks, Bekka. I didn't exactly pry on her specific knowledge of tests when I brought it up, as consults cost over $4-5 a minute.
But, yes, now that you bring up those spec. test names, some of them do sound quite familiar, esp. the tests w/ -"17" attached to them. What compounds the problem is that some offices differ in names of what each test involves, and as a novice, I don't always know the proper questions to ask (i.e, "thyroid panel". Well, does it involve more than just the TSH levels, such as T3, T4, or Reuptake T4, or even free T7? I hope that example made sense).
I have gone to a few endocrinologists in my life, but none specifically for HPA dysregulation.
Isn't ACTH stimulation test the same as my aforementioned 'dexamethazone suppression test'?
Thanks again, A.
> Hi. I think it would be helpful for you to consult with an endocrinologist. I'm surprised that your psychiatrist said that she is not getting information from the psychiatric community on this topic. Cortisol and HPA axis (hypothalamic-pituitary-adrenal axis) dysregulation are among the most important issues in biopsychiatry and psycho-neuroendocrinology today. There are many tests for HPA axis dysfunction; to mention just a few, there are tests for plasma cortisol, 24-hour urinary free cortisol, urinary 17-ketosteroids, urinary 17-hydroxycorticosteroids, ACTH stimulation tests, and others.
Posted by BekkaH on August 9, 2003, at 0:46:45
In reply to Re: tests to check CORTISOL levels - Bekka, posted by Anonne on August 7, 2003, at 23:38:10
> Thanks, Bekka. I didn't exactly pry on her specific knowledge of tests when I brought it up, as consults cost over $4-5 a minute.
Hi Anonne. Wow! $4-$5 per minute?!! You must be in the New York area. That's just about the going rate around here.
>> > Isn't ACTH stimulation test the same as my aforementioned 'dexamethazone suppression test'?
>> Thanks again, A.
No, the ACTH stimulation test is not the same as the dexamethasone suppression test. The dexamethasone suppression test is not used much in psychiatry these days, but it is used routinely by endocrinologists to test for the ability to suppress cortisol in response to dexamethasone.
Posted by Janmar on August 14, 2003, at 23:15:47
In reply to Re: Cortisol , posted by SLS on August 5, 2003, at 8:15:54
>
> > I've been on Paxil, Zoloft, Welbutrin, Celexa, Lexapro, Prozac, none has ever seemed to do anything. The thing that made me feel sort of normal was Ritalin. But that has lost its effectiveness now.
>
> > Is there a drug that lowers cortisol and its effects?
>
> There are two that come to mind, however, I think you should concentrate more on treating the depression, and let the antidepressants do the work on the cortisol.
>
> 1. ketaconozole
> 2. mifepristone (RU-486)
>
> I think you should try Effexor first before moving on to other antidepressants. Have you tried a tricyclic antidepressant or an MAOI (monoamine oxidase inhibitor) like Parnate or Nardil?
>
>
> - Scott
Thanks for your post and info.I have tried Effexor, forgot to mention that one. It made me weirdly sleepy, I could hardly keep my eyes open.
I think my brain is fried. Ritalin is the only thing that makes me feel good, and not as good as it used to. It must be working as an upper for me and not what it's supposed to be for ADD.
I think I've been prescribed all the easy antidepressants. Do those you mentioned have more/worse side effects?
This is the end of the thread.
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