Posted by Pfinstegg on April 7, 2003, at 16:03:37
In reply to Mifepristone question » Pfinstegg, posted by Frog on April 7, 2003, at 12:28:41
Dear Frog..it's good to hear that you are not having any side effects from the Marsilid. Although we here in the US have the MAOIs Parnate and Nardil, we are not familiar with Marsilid. I do not have any personal experience with the MAOIs, but have you noticed how many favorable reports there are about them here on Psychobabble? I hope you also have a very good and successful experience.
My understanding of mifepristone is that it is an excellent 7-10 day treatment to bring people out of a severe depression by lowering their 24-hour cortisols to normal, and it's in accord with what you say- that people afterwards need maintenance treatment with an anti-depressant. Your endocrinologist will know for sure, but I think a course of mifepristone, which is a form of sex hormone, could safely be followed by Marsilid.
As you know, there are two ways to study cortisol levels: the first is the 24-hour cortisol; when this is elevated, which happens only in a small percentage of depressed people, it means that the depression is quite severe. The second way is the Dexamethasone Suppression test. You take a baseline 8 AM serum cortisol, then, that night, you take 1 mg. of Dexamethasone. The following morning you take another 8 AM serum cortisol. A normal reading on the second morning would be 5 or less. If it is greater than 5, and especially if it is just the same as it was on the first morning, you have Dexamethasone non-suppression which is the hallmark of over-reactivity of your Hypothalamic-Pituitary-Adrenal Axis, and the most common endocrine finding in depression. If you just have DST non-suppression, Marsilid alone may be enough to give you a remission. But if you have elevated 24-hour cortisols in addition, it would be very worthwhile to consider a 7-day course of mifepristone followed by the Marsilid.
Keep letting us know how you are doing.
Pfinstegg
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URL: http://www.dr-bob.org/babble/20030407/msgs/217085.html