Posted by Elroy on October 15, 2005, at 19:49:01
In reply to Re: remeron and cortisol - The immortal thread ?!, posted by glenn on October 15, 2005, at 14:07:41
> I am pleased that the remeron seems to have done the trick for you.
> However the ONLY med that did it for me was xanax, strange as it does not have as far as I am aware a particular anti cortisol effect, but then my ilness was rather strange anyway , ie no panic attacks for example.
> Still strange though as I said years ago , that if remeron is so wide acting that it does not have a better reputation ?!
>
> GlennWell, many psych docs don't even know about the connection between cortisol (hypercortisolism) and many types of anxiety and / or depression. So why / how would they know about the few studies that show the anti cortisol benefits of Remeron? And if they did know about those studies they would probably think "so what"? Since they don't know about the "cortisol connection" to start with!
As to your Xanax (and mine too as it was the only med that I could initially find that would put the brakes on the raging anxiety)???
Well, it turns out that it too has anti-cortisol benefits. Did you know that, or was your doc aware of actual studies showing that benefit? Want to bet on how many psych docs are completely unaware of that?
Check out:
http://www.anthropogeny.com/A%20Hypothetical%20Explanation%20of%20Panic%20Disorder.htm
In that study it refers to a previous study -
Kroboth, P., Salek, F., Stone, R., Bertz, R., and Kroboth, F. 3rd. Alprazolam increases dehydroepiandrosterone concentrations. J Clin Psychopharmacol. 1999; 19: 114-24.
QUOTE:
Alprazolam increases dehydroepiandrosterone concentrationsKroboth PD, Salek FS, Stone RA, Bertz RJ, Kroboth FJ 3rd. Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pennsylvania 15261, USA.
The gamma-aminobutyric acid (GABA) agonist alprazolam is known to decrease adrenocorticotropic hormone and cortisol concentrations. Dehydroepiandrosterone (DHEA) is secreted synchronously with cortisol by the adrenal glands and demonstrates diurnal variation.
The major objective of this study was to determine whether alprazolam affects concentrations of DHEA and DHEA-S, the sulfated metabolite. In vitro studies have demonstrated that DHEA-S, and perhaps DHEA, have GABA antagonistic activity. Another objective was to determine whether DHEA-S and/or DHEA concentrations are related to psychomotor impairment after alprazolam. Thirty-eight healthy volunteers (25 young men, aged 22-35, and 13 elderly men, aged 65-75) received a single intravenous dose of alprazolam 2 mg/2 min (part 1).
Fifteen young and 13 elderly men responded to alprazolam and agreed to participate in part 2 of the study, which was a crossover of placebo and alprazolam infusion to plateau for 9 hours. Plasma samples at 0, 1, 4, and 7 hours were assayed for steroid concentrations.
Alprazolam produced:
(1) significant increases in DHEA concentrations at 7 hours in both young and elderly men;
(2) significant decreases in cortisol concentrations; and
(3) no change in DHEA-S concentrations.The relationship between psychomotor decrement and DHEA concentrations at 7 hours after alprazolam 2 mg/2 min was described by a u-shaped curve (p < 0.0047). Both the linear and quadratic components of the equations for the tests were significant (p < 0.002). These results suggest that alprazolam modulates peripheral concentrations of DHEA and that DHEA and/or DHEA-S may have an in vivo role in modulating GABA receptor-mediated responses.
PMID: 10211912 [PubMed - indexed for MEDLINE]
END QUOTESo Xanax too has a track record of being an effective cortisol reducer (note: I personally do not believe that neither Remeron nor Xanax or even both will effectively reduce cortisol in situations where medical Cushing's conditions exist).
Interestingly I too had no real "panic attacks". I would have times when my anxiety levels would "spike" at higher levels, but even then did not experience the classical symptoms of panic attacks... just stronger levels of anxiety.
Also it seems to me that the cortisol reduction ability of Remeron only seems to come into play at doses of 30 mg or higher.
Elroy
X
X
X
poster:Elroy
thread:124535
URL: http://www.dr-bob.org/babble/20051010/msgs/567332.html