Posted by Elroy on May 27, 2005, at 17:22:53
In reply to Re: Severe Anxiety, Moderate Depression High Cortisol, posted by SLS on May 26, 2005, at 0:16:43
Thanks for info but endo will NOT go along with ketoconazole under any circumstance (too concerned about side effects). He is something of a Cushings specialist and is really stumped now that it has become officially "Pseudo Cushings".
He believes that the high cortisol levels are being caused by the severe depression (I keep telling him that the only depression that I have is about not getting better, that what I have is severe ANXIETY)... and that the cortisol levels will go down once the depression (anxiety) is relieved.
My pdoc thinks that the anxiety problem may have caused the HPA Axis to go dysfunctional, but that the elevated cortisol levels caused the huge jump in anxiety and is keeping the anxiety levels pumping (I have to admit that she has indicated that what I have is close to being a "psychotic depression" as that is defined by high anxiety and aditation levels). She has become a believer in getting the HPA Axis under control - but isn't up to speed with the pharmaceutical approach in doing that.
I did have some luck in talking my endo in letting me send him some documents pertaining to the RU486 therapy as relates to elevated cortisol, depression and "re-setting" the HPA Axis. Of course I haven't heard anything back from him.
One of the things that impresses me with the RU486 therapy is that it is a very SHORT-TERM program and thereby avoids normal RU486 side effects. In addition, RU486 is not only an FDA approved drug, but also was originally developed as an anti-cortisol treatement for Cushings patients (so it makes one wonder why my endo would be so negative about giving that therapy a try)....
X
X
X
X
Anyway, I finally
> > Any and all reasonable suggestions and comments or ideas would be appreciated....
>
> I can't guarantee that any idea I come up with will be reasonable, but it might be an interesting experiment for you to try taking ketoconazole to see if it helps at all - even slightly. It acts as a cortisol synthesis inhibitor, and is sometimes used for Cushings. Did you know that metyrapone is used in Europe to treat Cushings? If you can get a hold of that drug from Novartis and combine it with ketoconazole, it makes for a good antiglucocorticoid treatment.
>
>
> - Scott
>
poster:Elroy
thread:502852
URL: http://www.dr-bob.org/babble/20050527/msgs/503801.html