Posted by Pfinstegg on January 16, 2003, at 21:22:13
In reply to Re: Cortisol testing, posted by jerrympls on January 16, 2003, at 20:12:20
I hope you will let us know what the tests show. Are you having a DST suppression as well as a 24-hour cortisol? I had the impression, also, that my endocrinologist really didn't know what to offer, other than adding T3 to the T4 I was already taking. But knowing what those tests show can help you make good decisions yourself.
If you have a high 24-hour cortisol, you could consider going into one of the studies of mefipristone, which has been reported to eliminate depression, and bring cortisol rapidly back to normal (within 7 days)- there are studies going on at Stanford and NIH. I think that would be much safer than trying something like ketanozodole,which, although it is used by endocrinologists for elevated cortisol in Cushing's Disease, can cause impaired liver function.
If you have DST non-suppression, but normal 24-hour cortisol, the treatment that will probably work the best would be ECT or TMS. (I'm assuming that you have a treatment resistant depression). I should add, though, that you could keep looking for an effective AD (maybe a tricyclic, MAOI inhibitor or atypical antipsychotic)- if you find one that really helps, it will be helping your cortisol as well. There are reports of this occurring on Medline- but there just aren't very many as yet. I think the concept of abnormal cortisol metabolism being central to PTSD, anxiety disorders and depressive disorders is sufficiently new that careful research on the effects of medications on cortisol just hasn't been done yet.
Please let us know what happens.
Pfinstegg
poster:Pfinstegg
thread:136050
URL: http://www.dr-bob.org/babble/20030113/msgs/136183.html