Posted by JohnX on February 21, 2001, at 3:58:39
In reply to Re: This theory is reversed for me, posted by JohnX on February 21, 2001, at 3:53:00
Oops, typo. In the hypocotisolemia case there
is hyper-supression of cortisol in the feedback
loop not hypo-surpression.
> In hypocortisolemia the opposite can occur.
> This is less common. *Really* chronic stress or
> traumatic episodes may contribute to Adrenal
> insufficiency. There are also many other medical
> reasons (disease or what not) too.
> Since the Adrenal glands produce adreno-cortisol
> but the Adrenal glands are impaired,
> the baseline cortisol levels are chronically low
> causing the CRs to up-regulate (increased sensitivity). This may lead to hypo-surpression
> in the feedback loop. The up-regulation of the
> CRs can also impact brain activity in a way that
> causes depression. These patients probably need
> to receive steroid injections in order to correct
> the problem. Any comments Shirly?
>
> Anyways, that's what I've read.
>
> -John
>
>
>
>
> > >
> > > Sherry
> > >
> > > Prednisone augmentation in treatment-resistant depression with fatigue and hypocortisolaemia: a case series
> > >
> > > Bouwer C, Claassen J, Dinan TG, Nemeroff CB
> > >
> > > Department of Psychological Medicine, University of Otago University, Dunedin, New Zealand. colin.bouwer@stonebow.otago.ac.nz
> > >
> > > [Record supplied by publisher]
> > >
> > > Abnormalities of the hypothalamic-pituitary-adrenal (HPA) axis have long been implicated in major depression with hypercortisolaemia reported in typical depression and hypocortisolaemia in some studies of atypical depression. We report on the use of prednisone in treatment-resistant depressed patients with reduced plasma cortisol concentrations. Six patients with treatment-resistant major depression were found to complain of severe fatigue, consistent with major depression, atypical subtype, and to demonstrate low plasma cortisol levels. Prednisone 7.5 mg daily was added to the antidepressant regime. Five of six patients demonstrated significant improvement in depression on prednisone augmentation of antidepressant therapy. Although hypercortisolaemia has been implicated in some patients with depression, our findings suggest that hypocortisolaemia may also play a role in some subtypes of this disorder. In treatment-resistant depressed patients with fatigue and hypocortisolaemia, prednisone augmentation may be useful.
> > >
> > > PMID: 10999245
> > >
> > > --------------------------------------------------------------------------------
poster:JohnX
thread:54520
URL: http://www.dr-bob.org/babble/20010212/msgs/54553.html