Posted by Pfinstegg on October 19, 2002, at 15:51:36
In reply to Remeron and cortisol, posted by linkadge on October 19, 2002, at 14:25:37
Does anyone know which AD's, exactly, either suppress cortisol production or protect the brain (hippocampus) from its damaging effects? I know those actions are cited for Remeron and also for the SSRI's, but does anyone really know? Has anyone found research which actually shows that an AD lowers blood cortisol or allows the hippocampus to regain normal size by MRI? I have only found three research papers, so far, which show that tianeptine does both of these things in tree shrews and rats. I haven't found anything about what it does in human beings, even though it has been used in Europe for a number of years. I have also found several articles which show that mefipristone and rTMS lower the circulating serum cortisol in human beings- and ONLY when these treatments are successful in relieving the depression. That's very specific and very exciting! But I have not yet found any research about any successful treatments for depression in which MRIs, PET or SPECT scans show abnormally shrunken hippocampuses returning to normal size, although I have seen several articles showing the association of depression with abnormally small hippocampuses and left pre-frontal areas, along with decreased cerebral bloodflow to these areas. I assume that brain and cortisol measurements must now be part of all well-done new studies of anti-depressant treatments, whether they involve medications or neurophysiological procedures, but that it's too early to publish results.
Also, when you have undergone sufficient stress to have your cortisol get permanently elevated, it seems to me from my own experience and that of a number of other posters here that other hormones levels become abnormal as well- for example thyroid, testosterone and estrogen. This is, of course, in addition to abnormalities in the transmission of serotonin, nor-epinephrine and dopamine, and probably lots of other neurotransmitters that no-one knows about yet. In the articles that I have read, CRF-CRH-ACTH-cortisol abnormalities lead to a "final common pathway" which causes all the other neurotransmitters to function abnormally, and the brain itself to become structurally altered.I hope people aren't starting to think "oh no, here comes Pfinstegg going on about cortisol again"! Actually, that would be a natural reaction, but, now that I have developed pseudo-Cushing's Syndrome myself in the aftermath of childhood PTSD, I am very aware of how little medical help is available. I feel that I have to be my own doctor, gathering the latest articles and showing them to my psychiatrist and endocrinologist, and suggesting possible treatments to them!
That's where you have been so helpful; there is always someone here who knows something that I don't, and, thanks to you, I learn something valuable on an on-going basis. If it weren't for some of you, I would probably never have known enough to go and get diagnosed properly. I keep posting here, and trying to keep in touch, because I know that this is where I will probably learn first what the best treatment should be for pseudo-Cushing's caused by stress.
Well, thanks again, everyone!
Madame Cortisol
poster:Pfinstegg
thread:124268
URL: http://www.dr-bob.org/babble/20021019/msgs/124279.html