![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 33 to 57 of 93. Go back in thread:
Posted by Ron Hill on April 7, 2003, at 16:59:52
In reply to Re: Cortisol and DHEA Balance, posted by jrbecker on April 7, 2003, at 16:09:26
JRBecker,
Thank you for sharing your experience with DHEA and preg.
> Just to add further confusion to the debate, I have used both pregnenolone and DHEA as daily supplements for atypical symptoms. I find that pregnenolone is much more potent than DHEA at equal dosages. Not sure why, but perhaps it's because pregnenolone is not only used to manufacture DHEA but also produce cortisol. Since I'm an atypical case, I don't believe Preg has a damaging effect on my depression due to its cortisol connection.
So is it your belief that atypical depression (i.e.; low motivation, anhedonia, anergy, hypersomnia, etc) is not correlated with elevated levels of cortisol?
-- Ron
Posted by Larry Hoover on April 7, 2003, at 19:21:50
In reply to Re: Cortisol and DHEA Balance » Larry Hoover, posted by Ron Hill on April 7, 2003, at 16:35:28
> Larry,
>
> > I have trouble with mechanistic explanations. I'm more comfortable with empiricism. What do people feel like when they take DHEA? I don't need to know why. I'm interested in whether.
>
> Okay, then let me try it this way. Have you ever taken DHEA? If no, why not? If yes, how did it make you feel and why did you stop (I'm assuming you do not take it currently)?Frankly, after looking at the subject anew, I don't know why I'm not taking any. I *have* used it before, but I don't really recall why I *don't* use it now. All I can come up with is a general resistance to mucking about with hormones. After refreshing my awareness about DHEA, I walked down the hall and swallowed 50 mg.
> > I've never seen DHEA in 5 mg doses, but that doesn't mean it isn't out there.
>
> Yeah, I bought a bottle of 5 mg DHEA tablets yesterday. I am a very med sensitive person.Me too. I never saw anything smaller than 25 when I last looked.
> > Surprisingly, I had trouble finding appropriate abstracts. Recently published studies had no abstract available.
>
> Thank you very much for your time Larry. The abstracts were very interesting.
>
> -- Ron
>
> P.S. I promise not to bug you endlessly.I promise not to be bugged....
Lar
Posted by Ron Hill on April 7, 2003, at 22:45:09
In reply to Re: Cortisol and DHEA Balance, posted by Larry Hoover on April 7, 2003, at 19:21:50
Larry,
> Frankly, after looking at the subject anew, I don't know why I'm not taking any. I *have* used it before, but I don't really recall why I *don't* use it now. All I can come up with is a general resistance to mucking about with hormones. After refreshing my awareness about DHEA, I walked down the hall and swallowed 50 mg.
Dude, you are way more impulsive than what I had you figured to be! It's kind of late in the day to be taking an activating substance like DHEA. I hope you can sleep okay tonight. If you get a chance tomorrow, let me know what it feels like in your brain.
> I promise not to be bugged....
I like your assertive attitude. Do what you gotta do to keep yourself healthy. If I can ever be of any help to you, be sure to let me know.
-- Ron
Posted by jrbecker on April 8, 2003, at 0:39:06
In reply to Re: Cortisol and DHEA Balance » jrbecker, posted by Ron Hill on April 7, 2003, at 16:59:52
> So is it your belief that atypical depression (i.e.; low motivation, anhedonia, anergy, hypersomnia, etc) is not correlated with elevated levels of cortisol?
>
> -- Ron
Ron,good question. It seems very likely based on the research that excessive cortisol plays a fairly direct role in causing the onset of depression. Although I think the issue is somewhat more complicated in atypical cases than in melancholic types. George Chrousos and Philip Gold of NIMH as well as Charles Nemeroff of Emory are some advocates for the role of the CRH pathway in terms of its more direct role [than monoamine metabolites] in the cause of depression.
A good read that might be a knowledgeable summary for those unfamiliar with this might be:
Organization of the stress system and its dysregulation in melancholic and atypical depression: high vs low CRH/NE states. PW Gold 1 and GP Chrousos 2. Molecular Psychiatry 2002, Volume 7, Number 3, Pages 254-275
To give a basic synopsis, it is hypothesized that in melancholic depression, the CRH pathway is being chronically stimulated, which simplifies to Corticotropin-releasing hormone --> ACTH --> Cortisol and NE release. This leads to the "typical" symptoms of depression due to chronic stress activation: low appetite, little sleep, anxiety, fearfulness of what the future holds, etc.In atypical depression, the stress system has pretty much fallen into disrepair. Whether it's because all atypicals were once melancholic in nature whose stress systems' have now crashed... well this is unknown. What is known is that atypical and melancholics have been found to be genetically distinct based on twin studies. Accordingly, many experts are beginning to think of the two types as completely different illnesses altogether. It's been shown that people with lower cortisol are more prone to PTSD, so perhaps there is a difference in predisposition that separates melancholics from atypicals as well.
Back to the stress system. It is believed that CRH is down-regulated in atypical sufferers (possibly due partly to feedback inhibtion from cortisol itself). Secondly, it is unclear whether cortisol itself is lower as well (there have been both studies that have measured high levels of cortisol as well as some that measured low levels of cortisol). Either way, it points to a problem of dysregulation of the stress system.
Another monkey wrench to throw into this theorizing is the idea of atypical depression as an offshoot of bipolar depression. There seems to be some good evidence of this when looking at the overlap of biplar II sufferers who have very comparable atypical features. If this is indedd the case, it might even suggest that atypical depression and that of bipolar illness have totally other mechanisms at fault besides the stress system.
In many ways, CRH and cortisol have been branded as conditionally "bad." However, this is in cases where it is being chronically overstimulated. CRH in the brain has been shown to be sort of like an endogenous cocaine. It increases dopamine and norepinpehrine release and has been related to all forms of primal drive and motivation. So, at normal levels it's a pretty good thing. Ron, this is where I actually answer your question specifically. Is excessive cortisol at fault for anhedonia? Yes seems to be the simple answer. Excessive cortisol is known to damage hippocampal regions of the brain as well as play a feedback stopgap to further CRH output. It is well known that this is what is occuring overtime in melancholic brains. Is this happening in atypical brains? My guess would be yes, but not to the same extent. Hippocampal damage(manifestation of atypical features) as well as low CRH (a major role in anhedonic symptoms) are major players in the illnesses' dabilitating effects. Whether anhedonic symptoms is due to ~current~ excessive cortisol is not clear. Unfortunately, a backwards way to correct this problem in atypical cases would be the introduction of a CRH potentiator to rejump the pathway. Who knows if this is the end-to-all-answers solution though.
What I do know is that stimulants, cocaine, exercise, selegiline, testosterone-replacement, and nicotine have all temporarily lifted my anhedonia. So obviously it's a Dopamine/NE connection, but it seems CRH is the more likely direct candidate at fault.
As for why I take the pregnenolone over the DHEA. I really can't say why. I don't know if in the end it's actually interefering somehow with my antidepressive treatment. But my belief is that it seems to have a more direct increase of dopamine through modulation of GABA than does DHEA. So maybe that's why I might be seeing more benefits in comparison to DHEA at equal doses. At the same time, it can also cause more anxiety. Either way, both supplements are somewhat similar in the end. As I mentioned before, the safer bet may be the DHEA.
JB
Posted by Larry Hoover on April 8, 2003, at 7:19:38
In reply to Re: Cortisol and DHEA Balance » Larry Hoover, posted by Ron Hill on April 7, 2003, at 22:45:09
> Larry,
>
> > Frankly, after looking at the subject anew, I don't know why I'm not taking any. I *have* used it before, but I don't really recall why I *don't* use it now. All I can come up with is a general resistance to mucking about with hormones. After refreshing my awareness about DHEA, I walked down the hall and swallowed 50 mg.
>
> Dude, you are way more impulsive than what I had you figured to be!Was that impulsive? Didn't feel like it from this end. I'd been mulling over using it for some time, I guess, and the research clinched it for me.
>It's kind of late in the day to be taking an activating substance like DHEA. I hope you can sleep okay tonight. If you get a chance tomorrow, let me know what it feels like in your brain.
I had a small difficulty going to sleep, but I had the same problem the night before, too (no DHEA), which I attributed to the time change.
> > I promise not to be bugged....
>
> I like your assertive attitude. Do what you gotta do to keep yourself healthy. If I can ever be of any help to you, be sure to let me know.
>
> -- RonDeal. <handshake>
L8r,
Lar
Posted by johnj on April 8, 2003, at 9:33:01
In reply to Re: Cortisol , posted by jrbecker on April 8, 2003, at 0:39:06
Great article, kind of hard since I am not versed in the technical terms. A few questions.
1) If the hippocamus is damaged, and I thought I read something about it regenerating cells every day, is repair with the right meds/supplements possible after a long term illness? I understand this is hard to answer, but what I can see in myself is a long term 6 month stressful event leading up to a crash about 1.5 years ago. I take lithium, a TCA, and a benzo, and all my pdoc did was increase my benzo when I had more anxiety and could not sleep. I guess I am looking at ways I can help reduce cortisol and/or stress effects. Or maybe I just need more rest since the period of high stress that I experienced. I had been pretty much symptom free for almost 8 years at that time.
What is out there that is close to a CRH or do most AD's act on cortisol is some way? Would it be advisable to see what my cortisol/DHEA levels are and if they are in the normal range? But, what is normal for me is the question too. I am med sensitive and the only herb/supplement I have tried that hasn't caused more anxiety is Mg. SAM-e made me more anxious. I was a biology major, but I can tell I need to bone up on things since I get lost rather quick in abstracts, recently concentration and motivation have been a big problem. Thank you
johnj
Posted by Ron Hill on April 8, 2003, at 9:53:39
In reply to Re: Cortisol , posted by jrbecker on April 8, 2003, at 0:39:06
JRB,
Thank you very much for taking the time necessary to type-up your detailed response. I need some time to chew on the information you have provided in your post and in the linked article. After I have it digested (to the extent allowed by my capabilities), I may need to get back to you with a follow-up.
Thank you friend.
-- Ron
-------------------------
> Ron,
>
> good question. It seems very likely based on the research that excessive cortisol plays a fairly direct role in causing the onset of depression. Although I think the issue is somewhat more complicated in atypical cases than in melancholic types. George Chrousos and Philip Gold of NIMH as well as Charles Nemeroff of Emory are some advocates for the role of the CRH pathway in terms of its more direct role [than monoamine metabolites] in the cause of depression.
>
> A good read that might be a knowledgeable summary for those unfamiliar with this might be:
>
> Organization of the stress system and its dysregulation in melancholic and atypical depression: high vs low CRH/NE states. PW Gold 1 and GP Chrousos 2. Molecular Psychiatry 2002, Volume 7, Number 3, Pages 254-275
>
> http://psyphz.psych.wisc.edu/front/740%20Class%20Spring%202003/Gold%20%20Organization%20of%20the%20stress%20system.pdf
>
>
> To give a basic synopsis, it is hypothesized that in melancholic depression, the CRH pathway is being chronically stimulated, which simplifies to Corticotropin-releasing hormone --> ACTH --> Cortisol and NE release. This leads to the "typical" symptoms of depression due to chronic stress activation: low appetite, little sleep, anxiety, fearfulness of what the future holds, etc.
>
> In atypical depression, the stress system has pretty much fallen into disrepair. Whether it's because all atypicals were once melancholic in nature whose stress systems' have now crashed... well this is unknown. What is known is that atypical and melancholics have been found to be genetically distinct based on twin studies. Accordingly, many experts are beginning to think of the two types as completely different illnesses altogether. It's been shown that people with lower cortisol are more prone to PTSD, so perhaps there is a difference in predisposition that separates melancholics from atypicals as well.
>
> Back to the stress system. It is believed that CRH is down-regulated in atypical sufferers (possibly due partly to feedback inhibtion from cortisol itself). Secondly, it is unclear whether cortisol itself is lower as well (there have been both studies that have measured high levels of cortisol as well as some that measured low levels of cortisol). Either way, it points to a problem of dysregulation of the stress system.
>
> Another monkey wrench to throw into this theorizing is the idea of atypical depression as an offshoot of bipolar depression. There seems to be some good evidence of this when looking at the overlap of biplar II sufferers who have very comparable atypical features. If this is indedd the case, it might even suggest that atypical depression and that of bipolar illness have totally other mechanisms at fault besides the stress system.
>
> In many ways, CRH and cortisol have been branded as conditionally "bad." However, this is in cases where it is being chronically overstimulated. CRH in the brain has been shown to be sort of like an endogenous cocaine. It increases dopamine and norepinpehrine release and has been related to all forms of primal drive and motivation. So, at normal levels it's a pretty good thing. Ron, this is where I actually answer your question specifically. Is excessive cortisol at fault for anhedonia? Yes seems to be the simple answer. Excessive cortisol is known to damage hippocampal regions of the brain as well as play a feedback stopgap to further CRH output. It is well known that this is what is occuring overtime in melancholic brains. Is this happening in atypical brains? My guess would be yes, but not to the same extent. Hippocampal damage(manifestation of atypical features) as well as low CRH (a major role in anhedonic symptoms) are major players in the illnesses' dabilitating effects. Whether anhedonic symptoms is due to ~current~ excessive cortisol is not clear. Unfortunately, a backwards way to correct this problem in atypical cases would be the introduction of a CRH potentiator to rejump the pathway. Who knows if this is the end-to-all-answers solution though.
>
> What I do know is that stimulants, cocaine, exercise, selegiline, testosterone-replacement, and nicotine have all temporarily lifted my anhedonia. So obviously it's a Dopamine/NE connection, but it seems CRH is the more likely direct candidate at fault.
>
> As for why I take the pregnenolone over the DHEA. I really can't say why. I don't know if in the end it's actually interefering somehow with my antidepressive treatment. But my belief is that it seems to have a more direct increase of dopamine through modulation of GABA than does DHEA. So maybe that's why I might be seeing more benefits in comparison to DHEA at equal doses. At the same time, it can also cause more anxiety. Either way, both supplements are somewhat similar in the end. As I mentioned before, the safer bet may be the DHEA.
>
> JB
>
>
>
Posted by Pfinstegg on April 8, 2003, at 9:54:35
In reply to Re: Cortisol and DHEA Balance, posted by Larry Hoover on April 8, 2003, at 7:19:38
Hi Larry... I think some people worry that if they take extra DHEA, they may raise their estrogen or testosterone levels over time, and be more at risk for breast or prostate cancer. (Relationship of serum dehydrepiantrosterone (DHEA) sufate, and 5-androstene, 3 beta, 17 beta-diol to risk of breast cancer in post-menopausal women, Cancer Epidemiol Biomarkers Prev 1997 Mar; 6(3):177-81) Although maybe somewhat less effective, 7-keto DHEA may help balance the DHEA-cortisol ratio, also, and it isn't supposed to be able to turn into either of those hormones in the body. (Preclinical Toxicology Evauation of 3-Acetyl-7-Oxo-Dehydoepiandrosterone, presented at Experimental Biology 98, April 19-22. San Francisco, CA by Humanetics Corp.)
But I must say that DHEA is interesting, with or without the 7-Keto. I found one study in which it was shown to prevent the uptake of cortisol into brain cells (Neurosteroid 7-hydroxylation products in the brain Int Rev Neurobiol 2001; 46:79-95), another which showed protection of the hippocampus from glutamate (Dehydroxyepiandrosterone protects Hippocampal Neurons against Excitatory Amino Acid-induced Neurtoxicity Proc Natl Acad Sci USA 1998 Feb 17;95(4):1852-7), and another which showed an increase in serum T3 without any change in TSH or T4 (A Randomized, DoubleBlind, Placebo-controlled Study of 3-acetyl-7-oxo-dehydroxyepiandrosterone in Healthy Overweight Adults, Humanetics Corp. The ones done by the Humanetics Corporation should of course be taken with a grain of salt, since they are the manufacturers. Still, that could be three neuroprotective actions!
I take the 7-Keto form about twice a week, but would really like to see more studies on its safety before I take it more frequently.
Pfinstegg
Posted by Ron Hill on April 8, 2003, at 10:00:02
In reply to Re: Cortisol and DHEA Balance, posted by Larry Hoover on April 8, 2003, at 7:19:38
Posted by Larry Hoover on April 8, 2003, at 11:09:18
In reply to Pls tell me what the DHEA feels like in your brain (nm) » Larry Hoover, posted by Ron Hill on April 8, 2003, at 10:00:02
Posted by Larry Hoover on April 8, 2003, at 11:59:30
In reply to Re: Cortisol , posted by jrbecker on April 8, 2003, at 0:39:06
> A good read that might be a knowledgeable summary for those unfamiliar with this might be:
>
> Organization of the stress system and its dysregulation in melancholic and atypical depression: high vs low CRH/NE states. PW Gold 1 and GP Chrousos 2. Molecular Psychiatry 2002, Volume 7, Number 3, Pages 254-275
>
> http://psyphz.psych.wisc.edu/front/740%20Class%20Spring%202003/Gold%20%20Organization%20of%20the%20stress%20system.pdfI can't think of a recent occasion when I have so thoroughly read any paper as I have studied this one. Thank you very much for the link.
Of course, the obvious questions arising from this study amount to :"So what can we do about that?"
What strikes me are the similarities to the theories presented many years ago by Hans Selye. For an exceedingly brief explanation, go to:
http://www.healthnewsnet.com/gap.htmlNow, back in the '20s and '30s, when Selye first defined his concepts of stress reactions, there was no way to directly measure the biochemical characteristics of these states. Still, I see the echoes in the current paper. There have been a number of nutritional and herbal "treatments" suggested for the exhaustion phase of chronic stress, based primarily on "softer" science than that presented here, but probably finding increasing validity over years of refinement. It shouldn't take too much trouble to find those ideas.
There is another aspect to the effect of prolonged stress, one that is not even tangentially mentioned in the comprehensive review referenced above: oxidative stress. Dr. Pall has some compelling evidence for the cyclic "locking in" of pathological levels of peroxynitrite as a mediator of the debilitating effects of chronic fatigue, PTSD, and fibromyalgia. It's not a stretch to apply chronic oxidative stress to atypical depression.
Much to think about here. And well worth a re-read.
Lar
Posted by Ron Hill on April 8, 2003, at 12:07:50
In reply to Re: DHEA feels like clarity (nm) » Ron Hill, posted by Larry Hoover on April 8, 2003, at 11:09:18
Posted by Larry Hoover on April 8, 2003, at 12:36:16
In reply to Re: Profound clarity or just slight improvement? (nm) » Larry Hoover, posted by Ron Hill on April 8, 2003, at 12:07:50
Posted by Ron Hill on April 8, 2003, at 13:38:02
In reply to Re:Closer to profound than slight. (nm) » Ron Hill, posted by Larry Hoover on April 8, 2003, at 12:36:16
Posted by McPac on April 8, 2003, at 16:24:42
In reply to Re: Cortisol , posted by Larry Hoover on April 8, 2003, at 11:59:30
I scanned the long 22-page study and was already aware of Hans Selye's ideas. Larry asked, "So what can we do about that?"
Have any of you read about and tried Skilled Relaxation Therapy? I'm not just talking about passively listening to a tape with seagulls and the ocean in the background but rather "skilled relaxation" (can be many forms but the desired effect is to reach certain theta, even delta, states which releases the built up stress in the hippocampus). Herbert Benson's book "The Relaxation Response" is about this very process. It's not only for short-term effect but for long-term as well. The ancient Chinese practiced this 1,000's of years ago (meditation). The key is to achieve the lowered brainwave states. I could go on and on, just wondering if any of you have tried it?
Posted by johnj on April 8, 2003, at 19:18:47
In reply to Re: The Role of Cortisol in Atypical Depression » jrbecker, posted by Ron Hill on April 8, 2003, at 9:53:39
especially jrbecker for the link to the research. I went through the synopsis and waded through 20 minutes before I just couldn't digest anymore. My god, it sounded so familiar. I am seriously thinking about an endocrinologist and getting tested. Is our only hope DHEA right now? I fear it will cause anxiety from what I have read here.
Is pregnenolone less anxiety causing than DHEA? Great info and questions, thank you.johnj
Posted by Dave1 on April 8, 2003, at 20:11:52
In reply to Re: Cortisol , posted by jrbecker on April 8, 2003, at 0:39:06
HI,
When you talk about damage to the hippocampus, what specifically are you talking about. Cell death, damage to the cell, reversible damage. Whenever I ask my pdoc whether my depression is from brain damage, he says no its just a chemical imbalance.
Thanks,
Dave
Posted by Pfinstegg on April 8, 2003, at 21:04:00
In reply to Re: Cortisol , posted by Dave1 on April 8, 2003, at 20:11:52
It's my understanding that all the changes which occur in a hippocampus damaged by stress hormones are potentially reversible, because that particular part of the brain has so much plasticity. According to what I have read, the damage includes:
1. A stopping of the daily birth of new neurons in the CA-3 region. We are supposed to produce several thousand new neurons each day, and some neuroscientists think that just not producing these may result in depression.
2. Loss (death) of neurons which secrete and take up serotonin, nor-epinephrine, dopamine and maybe even cortisol itself (uptake only for that one). The neurons which survive have shortened dendrites, which probably means that they are not doing a normal amount of secreting or taking-up.
3. In terms of what can be seen on scans, an MRI often shows a small left hippocampus- up to 20% smaller- and a SPECT scan often shows decreased glucose uptake on the left side, meaning that the blood flow is decreased- a hallmark sign of depression.
Since the wonderful finding a few years ago that the hippocampus is really a self-renewing organ, and can probably overcome the terrible things cortisol does to it if we can just get it our adrenals to secrete it on a normal, as-needed basis, it's very understandable that some of the best neuroscientists in the world are focussing on that very thing.
Pfinstegg
PS I know you didn't ask me this question, but I just answered anyway! I very much hope that jrbecker will also answer, as his posts and references have been wonderful.
Posted by Dr. Bob on April 8, 2003, at 22:29:45
In reply to Larry, Ron, jrbecker, posted by McPac on April 8, 2003, at 16:24:42
> Herbert Benson's book "The Relaxation Response" is about this very process.
I'd just like to plug the double double quotes feature at this site:
http://www.dr-bob.org/babble/faq.html#amazon
The first time anyone refers to a book without using this option, I post this to try to make sure he or she at least knows about it. It's just an option, though, and doesn't *have* to be used. If people *choose* not to use it, I'd be interested why not, but I'd like that redirected to Psycho-Babble Administration:
http://www.dr-bob.org/babble/admin/20020918/msgs/7717.html
Thanks!
Bob
Posted by Questionmark on April 9, 2003, at 0:37:12
In reply to Re: Cortisol » Dave1, posted by Pfinstegg on April 8, 2003, at 21:04:00
... and meds:
Honestly now-- this really concerns me-- i understand that depression and anxiety and the associated high cortisol levels can damage the brain (esp. the hippocampus [?]), but do you think that any medications can as well (even those to COMBAT depression/ anxiety)? i mean excitotoxicity is a major means by which brain cells die (esp in the hippo.) right? So if certain drugs elevate neurotransmitter levels too high then can this be damaging? (Particularly maybe with a glutamatergic drug like modafinil cuz glutamate excitoxicity in the hippocampus seems to be a common means of neuronal death[?]) --Or heck with any psychoactive med though.? And like with alcohol i think the main way it kills brain cells is because at first it enhances GABA transmission and thereby decreases glutamate release, and then there is a rebound excess release of glutamate as the alcohol is eliminated. So could benzodiazepines possibly cause brain damage as well?
i have read articles discussing whether SSRIs can kill serotonergic neurons and whether amphetamines (or at least meth) can kill dopaminergic neurons. This may not have been proven but it hasn't been disproven either has it? i am concerned. And i CERtainly believe that antidepressant (or what have you) withdrawal can damage the brain and probably really elevate cortisol/stress levels. Ever since coming off Paxil a few months ago i've felt that my mind just hasn't been working right-- like seriously, i can't come up with words, my memory is just horRENdous, and, ah i dunno, i just can't think. (i am currently not on any meds.) Many docs would probably just attribute this to the depression and relapse (er relapse- worsening) from Paxil. But i think that very often what they call RELAPSE is much more a factor of WITHDRAWAL (or just plain due to withdrawal). Relapse my ass.
i'm sorry this is so dam* long. But please provide some of your thoughts on this stuff.
Posted by Pfinstegg on April 9, 2003, at 8:48:47
In reply to Important questions regarding hippocampal damage.., posted by Questionmark on April 9, 2003, at 0:37:12
You have raised an extremely important question about the effects of various AD's themselves on the hippocampal neurons. I don't know as much about this as you do, as I haven't yet come across any articles about it; all the same, it is a concern which I share. The degree of both side effects and withdrawal symptoms from some ADs, particularly in the SSRI group, but also including the SNRIs, make me very uneasy as to whether they are causing harm in the long run.
Not having a more definite answer, I tend to rely on the reports of people here on PB who rely on fish oil, exercise, meditation, etc. plus SMALL doses of ADs and sometimes benzos- often their dosages are considerably beow what would be considered therapeutic, but this seems to be a group in which treatment satisfaction is quite high. Have you noticed this also?
Pfinstegg
Posted by Ron Hill on April 9, 2003, at 9:45:03
In reply to Re:Closer to profound than slight. (nm) » Ron Hill, posted by Larry Hoover on April 8, 2003, at 12:36:16
Larry,
Did you take another 50mg dose of DHEA yesterday? How about today? Has the improved mental clarity subsided? What is your opinion of the usefulness of DHEA supplementation based on your early results of this most recent trial?
-- Ron
Posted by Larry Hoover on April 9, 2003, at 12:19:11
In reply to Re: DHEA Trial » Larry Hoover, posted by Ron Hill on April 9, 2003, at 9:45:03
> Larry,
>
> Did you take another 50mg dose of DHEA yesterday? How about today? Has the improved mental clarity subsided? What is your opinion of the usefulness of DHEA supplementation based on your early results of this most recent trial?
>
> -- RonI took 50 mg DHEA on arising, yesterday. I had a substantial increase in mental activity/acuity, and moderate insomnia once again. Frankly, I get a similar reaction to betaine. I didn't take DHEA today. I did take some NADH (sublingual this time), and the combination seems to be quite effective. I feel exceedingly sharp, and calm.
Lar
Posted by Larry Hoover on April 9, 2003, at 12:27:24
In reply to Important questions regarding hippocampal damage.., posted by Questionmark on April 9, 2003, at 0:37:12
It's only in the last decade that we've come to realize just how resilient the brain is. New cells are formed, and new connections between existing cells are created, every day of our life. Yes, there is some evidence for hippocampal injury during depression, but SSRIs have been shown to reverse that process. When SSRIs stop working, it may well be because the pathology of depression has found another way to injure the brain. SSRIs and all other antidepressants have been shown (via what is called functional neuroimaging) to "correct" some aspects of brain physiology, but not all of them. In a sense, then, antidepressants are an incomplete treatment. Disappointments over treatment outcomes or issues of antidepressant-derived brain injury may well be well be depression doing its dirty work despite treatment. That's why I focus on other aspects of self-care: feeding my brain what it needs, listening to my body *intently*, exercise, rest, cognitive/behavioural interactions, and so on. Depending solely on medication is a foolish decision, IMHO.
Lar
Posted by jemma on April 9, 2003, at 13:10:14
In reply to Re: Important questions regarding hippocampal damage.. » Questionmark, posted by Pfinstegg on April 9, 2003, at 8:48:47
I consider this to be absolutely the most critical question to ask regarding our use of meds. Namely, are they neuroprotective or neurodamaging? I took zoloft for nine years. The first year was great, and the second year it continued to have some mood-elevating effect. But then followed seven years of weight gain, increasing memory loss, numbness, apathy and lethargy, and chronic hormonal imbalance that resulted in various health problems. Yet I blame myself - had I read the printed material that comes with the pills, I could have seen for myself that "in animals, chronic use has been shown to result in downloading of catecholamine receptors." So I was suffering, as I'm sure many of us are, from a chronic and ever-worsening shortage of norepinephrine and dopamine.
Finally, my pdoc switched me to catecholamine- enhancing drugs, and after much trial and error, came up with the combination of modafinil and ritalin. I was awake for the first time in a decade! But I became increasingly wary of evidence that ritalin ultimately depletes, and even kills, dopamine cells. MOdafinil worried me less, as it's been shown to be neuroprotective. I know glutamate causes excitotoxicity, but gaba in excess is also toxic. My brain seems to need glutamate to feel awake. Anyway, I substituted selegiline for ritalin, and it worked even better for focus and concentration. And selegiline protects dopamine neurons, instead of killing them.
From now on, I am only interested in meds and supplements that protect my brain and promote its balance. Fortunately, such meds and supplements do exist, and I'm grateful to Larry, Pfinstegg, Scott, and so many others on this board who have helped me to find them.
- jemma
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