Posted by JohnX2 on March 31, 2002, at 19:57:54
In reply to Re: SSRI, adrenal exhaustion » JohnX2, posted by jazzdog on March 31, 2002, at 13:25:20
Hi Jane,A couple of quick thoughts. Please note, I'm swagging here a bit as I learn more about this stuff.
> Hi John -
>
> The thing that impressed me about the notion that ssri's have longterm implications for the endocrine system is that it gelled so well with my experience. When I first took zoloft, I had about a year of incredible well-being - energy, creativity, libido, a capacity for joy - it was like a reprieve from a lifelong anhedonic sentence. And only once before, on a two-week treatment with hydrocortisone - had I ever felt so well. Then began a long decline - my ability to cope with stress decreased, my energy disappeared, I gained weight, got very foggy-minded, and started sleeping excessively once again. I guess you'd call it poop-out. I developed a bunch of physical symptoms relating to a mild kidney ailment, so I started seeing an endocrinologist. I found out I had severe hyperinsulinism and low cortisol levels - this after eight years on zoloft. I never connected the two before, but when I ran across that website stating that ssri's caused hyperinsulinism and adrenal exhaustion, I felt a eureka moment. It's thanks to you that I started thinking about ssri's causing dopamine depletion, and this seemed to me to be a possible answer - don't the adrenal glands produce dopamine?
>I'm wondering if your mood elevation from the hydrocortisone prior to Zoloft administration is indicative that your depressive systems in terms of the HPA axis were "reversed" from what is typical. I.e. possibly you were predisposed to adrenal exhaustion or some sort of traumatic/prolonged stress that sent you into depression. There seem to be some good corralations between the type of depression seen in PTSD and what may be seen in an adrenal exhaustion. I.e. the depressed person shows lower than normal levels of circulating cortisol. This could cause the feedback glucoroticoid receptors in the brain to be overly "upregulated". Zoloft briefly from what I understand, can help to correct a maladaptive HPA axis in either case (the common case of hypercortisolemia or the less common case of hypocortisolemia). I believe this is why Zoloft has FDA approval for PTSD.
If this was your case, then the Zoloft may have been able to increase your cortisol/adrenal output by correcting glucoroticoid feedback receptor mechanisms. I don't want to speculate at this time what the long term affect of this would be.
For the vast majority of depressives, a hypercortisolemia state is noted.> I know this thinking would be greeted with skepticism by many psychiatrists, but here's the thing: psychiatrists seem unwilling to think outside the box of neural pathways - they seem to resist a more organically connected whole-body approach. This seems to be true in all medical disciplines - not seeing the forest for the trees. Also, most articles I read on mood stabilizers, ad's, and ap's seem to contain the sentence: 'the exact mechanism is not clearly understood.' Maybe we need more research into the endocrine - neural axis, expecially since so many neurotransmittors are manufactured by the adrenal/pineal/pituitary glands.
I agree with these comments.
I'm trying to better understand how neuroendocrines effect the monoamine system. They most certainly do interact. I'll let you know if come to any more interesting conclusions.Can I ask you a question:
Have your doctors been able to ascertain whether or not your adrenal glands are functioning in a healthy manner at this time? I.e. maybe your cortisol output is low, but you still have healthy adrenals?
John
>
> I'd be interested to hear your thoughts on this. I always value your opinion. :>)
>
> - Jane
poster:JohnX2
thread:100358
URL: http://www.dr-bob.org/babble/20020327/msgs/101163.html