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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 Shawn. T. on July 9, 2002, at 1:09:07
http://www4.infotrieve.com/newmedline/detail.asp?NameID=10451911&loggedusing=M&Session=98474&SearchQuery=mirtazapine+AND++%28noradrenaline+OR+norepinephrine%29&count=56
Remeron, aka Mirtazapine has been shown to reduce levels of cortisol in the bloodstream soon after the first dose. I think this study deserves a follow-up to determine how Mirtazapine affects cortisol levels in later stages of treatment, not just soon after initial treatment. I think this may explain why some people report feeling better soon after initiating treatment with Remeron. I would guess Mirtazapine's properties as a 5-HT2 or 5HT-3 antagonist would result in the lower levels of this stress affecting substance. I previously posted this as a reply, but I think it deserves its own thread.
Posted by Shawn. T. on July 9, 2002, at 18:09:15
In reply to Remeron shown to reduce cortisol levels, posted by Shawn. T. on July 9, 2002, at 1:09:07
I think I can prove this even without using the study I referred to. Remeron (mirtazapine) blocks 5-HT2 receptors and therefore reduces cortisol levels. This action is shared by most atypical antipsychotics, and this may explain why some people benefit from combinations of atypicals and SSRI's. What I've found has important implications for the ineffectiveness of SSRI's and the dietary supplement 5-HT. The fish oil DHEA has been shown to lower cortisol levels by the way (the last link). I would therefore argue that DHEA is an effective antidote to certain SSRI side effects. I believe this is because DHEA is a precursor to androgens, which decrease cortisol.
On 5-HT2 antagonism and cortisol:
http://www4.infotrieve.com/search/databases/detailsNew.asp?artID=7178095http://www4.infotrieve.com/search/databases/detailsNew.asp?artID=1054993
http://www4.infotrieve.com/search/databases/detailsNew.asp?artID=10831057
On adverse effects of cortisol:
http://www.psychosomaticmedicine.org/cgi/content/full/61/5/698On paxil:
http://www4.infotrieve.com/search/databases/detailsNew.asp?artID=18838258On DHEA:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&list_uids=9264158&dopt=Abstract
Posted by Doomed on July 10, 2002, at 0:00:57
In reply to SSRI's, 5-HT supplement shown to increase cortisol, posted by Shawn. T. on July 9, 2002, at 18:09:15
I really don't understand all of that technical jargon. I thought cortisol was good because it helped regulate a stress respone thereby protecting the body and bad because it meant there was a stress response? There are treatments for Addison's disease (low cortisol) and Cushing’s syndrome (high cortisol) and I haven't heard of these being beneficial for anxiety and depression not caused by the disorders themselves. Maybe you were referring to just helping with drug side effects? Since drug companies are working on CRF antagonists further upstream of the cortisol they must think that the this intial response may be responsible for some of the misery anyway.
>The fish oil DHEA has been shown to lower cortisol levels by the way (the last link)
I think you've confused docosahexaenoic acid [DHA] found in fish oil with dehydroepiandrosterone [DHEA] a natural hormone produced by the adrenal glands. DHEA is inexpensive and can be purchased without a prescription just like fish oil.
Posted by katekite on July 10, 2002, at 21:54:59
In reply to SSRI's, 5-HT supplement shown to increase cortisol, posted by Shawn. T. on July 9, 2002, at 18:09:15
I'm starting to believe you on the remeron front. I'm such a skeptic. One 45 mg remeron dose put me to sleep for about 18 hrs then an amnestic hypnotic daze for the next two days. Horrible experience. Not that I doubt it works for some. Perhaps I just needed a higher dose.
Acutely the ssris raise cortisol but long term they supposedly normalize the HPA axis. Read that somewhere, at least.
You might like this rather technical on-line book that medlib (the wonderful medlib) recommended to me: http://www.acnp.org/g4/4thgen.php
Keep it up and figure out why my cortisol is high, will you?
Take care,
Kate
Posted by Shawn. T. on July 11, 2002, at 4:39:40
In reply to Re: SSRI's, 5-HT supplement shown to increase cortisol, posted by katekite on July 10, 2002, at 21:54:59
Thanks for the encouragement. Your statement that SSRI's normalize the HPA axis seems accurate to me. I'm determined to figure out SSRI poopout and maybe an eventual loss of ability to normalize the HPA axis could explain this. I would guess that the cause of the effect you describe relates to 5HT-1a autoreceptors in the raphe nucleus. Perhaps. Yet more reading for me to do.
Posted by cybercafe on July 13, 2002, at 10:22:59
In reply to Re: SSRI's, 5-HT supplement shown to increase cortisol, posted by Shawn. T. on July 11, 2002, at 4:39:40
i heard cortisol is responsible for premature aging.... is that true?
Posted by Shawn. T. on July 13, 2002, at 18:50:34
In reply to me thinks cortisol is bad , posted by cybercafe on July 13, 2002, at 10:22:59
I agree 110%. That's why I like drugs that contribute to reduced cortisol excretion. Also, I suggest that everyone get their cortisol levels checked out if at all possible. Anyone with abnormally low cortisol may not benefit very much from drugs like Remeron, M,100,907, and mianserin. Individuals who have experienced a great deal of abuse as a child or who have been diagnosed with chronic fatigue syndrome are particularly suggested to get their cortisol levels checked out. DHEA levels should be checked out as well; if my life were on the line, I'd have every single adrenal hormone level tested for. Note that I have read conflicted things about anxiety disorders and their relation to cortisol & DHEA, so I also suggest that they have their levels checked. I doubt many psychiatrists are unaware of what cortisol or DHEA is, so they'd probably agree to do it in a heartbeat. You may want to print out the following article or some of the information that I've been referring to in other posts. An idea that I especially like is the DHEA/cortisol ratio. See
http://www.lef.org/magazine/mag2001/aug2001_report_dhea_01.html"However, it could be argued that aging itself is, in a sense, a chronic inflammatory state."
That's an excellent statement in my opinion. I'm also pleased to find that a aromatase inhibitor exists; I'd like to think it may help anorexics. I think back to a movie involving anorexia nervosa that I once saw and grimace.
"both healthy rabbits and rabbits with extremely high cholesterol showed an increase in the activity of platelet superoxide dismutase (SOD), a crucial antioxidant enzyme."
That's so amazing; I like that finding a lot.
"In addition, DHEA has been shown to protect against the toxicity of the amyloid-beta protein and excess glutamate. Treatment with glutamate produced a copious increase in the neuronal glucocorticoid receptor. Treatment with DHEA reversed this increase, demonstrating again the anti-glucocorticoid action of DHEA."
Wow!
I would quote more, but I just wanted to convince everyone to read every single word of it. Tell your mom, your sister, your brother, your auntie, and your best friend. Tell them to have their cortisol and DHEA levels tested for. I don't know how much it costs to have other hormone levels tested for, but a test for those would be well advised as well.
This is the end of the thread.
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