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Re: Acne as AD effectiveness indicator » Journey

Posted by Cairo on December 11, 2005, at 8:46:36

In reply to EffexorXR and acne, posted by Journey on December 10, 2005, at 15:08:11

Please bear with my ramblings, but I've thought about this issue before because it intrigued me.

My daughter's acne was visibly better after switching from Lexapro to Zoloft. I believe SSRIs can both cause a problem with acne or improve it, depending on a drug's effect on cortisol and other neurotransmitters involved in an individual(see below) as well as a person's vitamin and mineral status. AD meds also affect DHEA and pregnenalone, etc. You have only to look at the biosynthesis of sterols

http://www.indstate.edu/thcme/mwking/steroid-hormones.html

to see that there are many pathways that convert cholesterol into cortisol, the female hormones and androgen, the male hormone. If medication affects cortisol, DHEA or female hormones, it might shunt the synthesis toward androgen or cortisol production in people genetically susceptible or deficient in vitamins or other cofactors needed in the various pathways. The point is that they're interrelated.

I've noticed that I also tend to get breakouts in my facial "T" area when I'm on medications that don't work for my atypical depression as well. I seem to have a sluggish HPA axis and have hypothyroid/hypoadrenal-like symptoms, though my labs come back normal. One hypothyroid symptom is acne and if I'm on a med that doesn't help my fatigue and depression or worsens them, my acne flares up. Only Cymbalta helped with energy and on it I saw an improvement in acne as well as less hair loss and thinning of the eyebrows (other hypothyroid symptoms), but I could not tolerate a dose higher than 5mg and at that dose it didn't help depression and higher doses caused unbearable akathisia. Going off it (to try other meds) saw the acne and hair loss worsen again. One symptom of excess cortisol is also acne, though my cortisol levels tend to be low.

So meds may also improve acne by lowering cortisol, boosting the HPA axis, etc:

http://www.dr-bob.org/babble/20010902/msgs/77712.html

My daughter was recently prescribed a med called Nicomide by her dermatologist. It has nicotinomide (also called niacinamide), zinc, copper and folic acid in it. It noticeable further improved her acne after only a week or two. I find it interesting that niacinamide acts on the benzodiazepine receptor, according to Larry Hoover on the PsychoBabble Alternative forum:

http://www.dr-bob.org/babble/alter/20050414/msgs/489221.html

She has social anxiety, so I wonder if Nicomide is somehow partially responsible for an improvement in her SA symptoms. She also started another med for SA at the same time, so it's hard to tell. Folic acid has been used for depression, also.

So I often look at my nose as one indicator if a med is working for my atypical depression. Weird, huh.

Cairo


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poster:Cairo thread:587806
URL: http://www.dr-bob.org/babble/20051211/msgs/587993.html