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a note to oldschool (if you're reading)

Posted by Elizabeth on April 4, 2002, at 23:05:46

In reply to Re: Kramer: whats right now ?, posted by OldSchool on April 3, 2002, at 21:10:08

> Prednisone causes major depression Dr. Kramer. My dx is unipolar major depression...severe melancholia. It was induced by prednisone. You do not know what you are talking about.

Steroids have unpredictable mood effects, and different people with depression can have different types of endocrine abnormalities. But anyway, is it possible that your depression was triggered by withdrawal from prednisone? (Just curious.) Also, have you ever taken any of the various neuroendocrine tests that are sometimes used in depression? I wonder if ketoconazole -- a glucocorticoid antagonist -- might help you.

My understanding is that steroids are more likely to trigger manic, hypomanic, or mixed mood states than pure depression, but either is possible. Personally, I've only ever observed steroid-induced mania (the mixed/dysphoric/irritable type), never depression (haven't had the pleasure of trying them myself).

One last note: my recollection is that you've said you'd only been diagnosed with MDD, not melancholic features, and that at least one doctor identified mood-reactivity (which precludes melancholia). You've also described your depression and it didn't sound like melancholia to me. It's not a good idea to specify a diagnostic subtype that isn't really applicable; even though this forum is informal, you could easily end up getting advice or suggestions that aren't appropriate to your situation if people are misinformed as to what condition you suffer from. Much of the research on depression has distinguished melancholic and nonmelancholic depressions, so this is not a trivial distinction.

best,
-e


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poster:Elizabeth thread:101477
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