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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by dannen on December 12, 2003, at 17:52:46
Has anybody tried mefipristone (M) successfully? I am thinking of trying it, instead of ketoconazole (K).
Wolkowitz (spelling?) at UC-SF seems to suggest in one article that K is the preferred medication for treating hypercortisolemia. But I have heard K may be hepatoxic. W seems to suggest that M is not as good a choice as K(b/c/M blocks cortisol receptors instead of blocking cortisol production). Has anybody tried K or M--successfully? Has anybody looked at this issue?
I have super high cortisol (diurnal variation intact; very probably not Cushing's), for over one year. I am looking at ways to calm the HPA axis and get the cortisol down. I have tried (and continue with) yoga (including pranayama breathing), meditation, prayer, massage, ashwagandha (spelling?), phosphaditylserine (spelling?), lots of fish oil, daily swimming. But it won't come down. Morning anxiety is really terrible (4 am to 8 am especially).
I could not tolerate any of the SSRIs, nortrip, remeron, lamictal, or depakote. And so on. Neurontin worked for a while, but I had problems with it after a few months. I (male, late 40s) have never had any problems with anxiety or depression until summer of 2002, when my wife of over 20 years left me for reasons I still to not understand.
Any help on bring cortisol down would help--alternative or mainstream. Thanks.
Dannen
Posted by SLS on December 13, 2003, at 8:08:24
In reply to Mefipristone vs. ketoconazole for high cortisol , posted by dannen on December 12, 2003, at 17:52:46
There are several ongoing trials using mifepristone (RU-486) to treat depression that are being funded by the NIMH. One trial found it to work well for psychotic depression. I don't remember where I read it, but it was stated that mifepristone was administered acutely for a short period of time upon which the depression resolved. The drug was then discontinued, and the antidepressant effect persisted long afterwards. I think the idea is to force the HPA to reset itself to a more normal state.
Are you considering trying it?
- Scott
Posted by dannen on December 13, 2003, at 13:42:40
In reply to Re: Mefipristone vs. ketoconazole for high cortisol , posted by SLS on December 13, 2003, at 8:08:24
Scott. Thanks. I know about the trials. There are about 30 regional studies nationwide. I was hoping to hear from someone who had participated in one of the trials.
I believe that mefipristone can be obtained from Danco through its compassionate use for mifepristone program (apparently administered by the Feminist Majority Foundation), if one's doctor submits certain forms and/or meets certain requirements/protocals. The person apparently in charge of that program, Beth Jordan, M.D. has been very helpful and responsive in emails. (I am impressed; it speaks well for her, her organization, and Danco.) I was referred to the researchers at Stanford for more information (J. Belanof, MD and C. DeBattista, MD).
Again, thanks for the input. If anyone has any information on mefipristone, such as side effects, efficacy, dosage, time taken, and so on, please respond. Especially, would it work with my severe morning anxiety caused by high cortisol? I hope to start the process of trying to obtain this drug for a trial this next week.
Dannen
Posted by SLS on December 13, 2003, at 15:04:13
In reply to Re: Mefipristone vs. ketoconazole for high cortisol , posted by dannen on December 13, 2003, at 13:42:40
Hi Dannen.
> I believe that mefipristone can be obtained from Danco through its compassionate use for mifepristone program
Thanks for all of the information. Would you be able to give me e-mail addresses or phone numbers?
> I hope to start the process of trying to obtain this drug for a trial this next week.I wish you luck. Please post of your progress.
- Scott
Posted by dannen on December 13, 2003, at 15:09:19
In reply to Re: Mefipristone vs. ketoconazole for high cortisol , posted by SLS on December 13, 2003, at 15:04:13
Scott. The email for Beth Jordan is bjordan@feminist.org, which I got from Danco. You can access Danco's website. Good luck.
I wonder why there are no posts by people who actually have tried mifepristone.
Dannen
Posted by SLS on December 13, 2003, at 15:14:39
In reply to Re: Mefipristone vs. ketoconazole for high cortisol , posted by dannen on December 13, 2003, at 15:09:19
Thanks again.
> I wonder why there are no posts by people who actually have tried mifepristone.
Someone has to be the guinea pig. :-)
You might be the first one here to try it.
- Scott
Posted by Ron Hill on December 13, 2003, at 16:29:03
In reply to Mefipristone vs. ketoconazole for high cortisol , posted by dannen on December 12, 2003, at 17:52:46
Dannen,
> Any help on bring cortisol down would help--alternative or mainstream. Thanks.
I'll just mention a couple alternatives here and then redirect to PB-alt.
In his book "The Cortisol Connection", Shawn Talbott, PhD recommends magnolia bark, l-theanine, epimedium, phytosterols, phosphatidylserine, tyrosine, and branched-chain amino acids for cortisol control.
I'm currently enjoying some benefit from l-theanine. It might help you, or it might not, but it’s likely worth a trial. Please read what is posted on this subject at PB-alt:
http://www.dr-bob.org/babble/alter/20031104/msgs/281539.html
-- Ron
Posted by dannen on December 13, 2003, at 18:00:25
In reply to Re: Cortisol Lowering Substances » dannen, posted by Ron Hill on December 13, 2003, at 16:29:03
Ron. Thanks for the post on cortisol lowering substances and the reference to Talbot's book, which I have looked at on-line, then couldn't find access to full book again. I take aswaghanda, vitamin C, fish oil, GLA, magnesium, selenium, multi-vitamin. I'm not sure how to obtain some of the other items Talbot mentions. I tried l-theanine. It seemed to depress me, oddly enough. Maybe I'll try it again. Dannen
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