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Prozac (Fluoxetine) and Other SSRIs Alter Cortisol and Cytokine Levels

Discussion in 'Other Health News and Research' started by Lotus97, May 12, 2013.

  1. Lotus97

    Lotus97 Senior Member

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    There seems SSRIs initially raise cortisol, but lower cortisol in long-term treatment (?)

    http://www.ncbi.nlm.nih.gov/pubmed/18805677


    http://www.ncbi.nlm.nih.gov/pubmed/22429479


    This last article was posted in a forum from another website (I didn't write it)
    http://survivingantidepressants.org/index.php?/topic/1147-cortisol-and-ssris/
     
  2. adreno

    adreno 3% neanderthal

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    SSRIs lowers cortisol in MDD because cortisol levels are high to begin with. In someone with low cortisol they would most likely increase it. So in a way they act to (at least partially) restore the HPA axis function.
     
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  3. jimells

    jimells Senior Member

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    This is very interesting. I've been subjected to more antidepressants than I can shake a stick at. Most of them seemed to help a little at first, then they made me much sicker. The idea that they may initially increase cortisol then reduce it could explain my reaction to these drugs, and is very troubling. It is truly outrageous that billions of these pills are handed out like candy, and the doctors have no idea what they are doing to the patients.

    As for me, I refuse to take any more of these medications.
     
  4. Lotus97

    Lotus97 Senior Member

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    I wouldn't recommend prescription medications except as a last resort, but for me many are necessary unfortunately. Treating the underlying condition and/or supplements would be a better option.
     
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  5. Ema

    Ema Senior Member

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    As someone with adrenal insufficiency, it has not been my experience at all that SSRIs and their ilk increase cortisol and restore the HPA axis function. I would say that those drugs were some of the worst I have ever taken in terms of exacerbating low cortisol symptoms. Cymbalta precipitated an adrenal crisis and nearly killed me.

    In my experience, they work by increasing cortisol in the short term but then in people prone to HPA axis dysfunction, they stop working when the adrenals can no longer continue to increase cortisol production. Then all hell breaks loose and doctors generally try to treat this by simply adding in more meds rather than treating the underlying dysfunction. It's a recipe for disaster in many cases.

    I think there is a place for antidepressant meds but I don't think that they should be handed out like candy the way they currently are. One of my doctors described them as using a sledgehammer to repair a fine watch. Sometimes it can be put back together and it works and other times you just end up with a mess of broken parts.

    Ema
     
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  6. caledonia

    caledonia

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    I don't know about lowering cortisol during use, but when you try to withdraw, it raises cortisol like crazy. I have the lab tests to prove it. My cortisol went from nearly a flat line (one of the 4 worst results my naturopath had ever seen), to values 5 times higher than normal. It was literally off the top of the chart! All kinds of horrible mental and physical symptoms go along with this.

    The solution is to taper extremely slowly to allow your brain and body time to adjust - I'm on a 3 year taper.

    This is just one bad thing that anti-depressants do. The other biggie is that they affect the serotonin receptors in your bone marrow, which can cause osteoporosis. This is just the tip of the iceberg. Nobody should be on these things.
     
    Lotus97 likes this.
  7. Lotus97

    Lotus97 Senior Member

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    As I mentioned earlier in this thread, going off my antidepressants right now isn't an option for me, but I hope after treating my Lyme disease and doing methylation for awhile I could maybe taper off of them. caledonia Thanks for the heads-up about the spike in cortisol from tapering/discontinuing SSRIs. Anyone know anything about Elavil/amitriptyline (a tricyclic antidepressant) and cortisol? I take that for sleep, but not during the day
     
  8. adreno

    adreno 3% neanderthal

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    TCAs (including amitriptyline) lowers cortisol.
     
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  9. jeffrez

    jeffrez Senior Member

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    Cymbalta's an SNRI, more similar to the TCAs. Like Adreno said, the research findings typically have been that cortisol is high in major depression. SSRIs as well as TCAs are most often discussed in terms of normalizing HPAA function, at least relative to what it is during the depression.
     
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  10. Lotus97

    Lotus97 Senior Member

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    It's true that prescription drugs can potentially cause a lot of problems, but it's important to note that supplements aren't without possible contraindications. For example, holy basil, chamomile, phosphatidylserine, Seriphos, skullcap, lemon balm/melissa, and ashwaghandha can all lower cortisol.
     
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  11. Ema

    Ema Senior Member

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    The research is apparently inconsistent on whether or not cortisol is high in major depression.

    http://www.ncbi.nlm.nih.gov/pubmed/19487626

    I think it is safe to say that the HPA axis and cortisol in particular are affected (positively or negatively) by antidepressants but I think it is premature to say that levels of cortisol are typically one way or another at this point.

    Ema
     
  12. Ema

    Ema Senior Member

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    I am still curious about whether or not the supplements that have been found to lower cortisol are actually adaptogens or if any of them really ONLY lower cortisol.

    I have wanted to try phosphatidyl serine for a long time but have been put off for fear of lowering my already non-existent cortisol levels. But PS is supposedly great at re-sensitizing the POMC neurons of the hypothalamus and normalizing cortisol production which may be exactly what those of us with HPA axis dysfunction need. One of these days I will work up my courage and give it a shot. I'm not convinced it will lower cortisol in those who are already low.

    Ashwagandha is also possibly adaptogenic. But in my experience, adaptogenic herbs seem to work best for those with high cortisol or high/low fluctuating cortisol patterns instead of all out low.

    I think it would be really helpful to have more studies on these herbs to learn more about how they work. Of course, no one wants to pay for anything that can't be patented.

    Ema
     
  13. Lotus97

    Lotus97 Senior Member

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    I have the same questions about those supplements. I've done searches for adaptogens and cortisol and haven't really been able to find much in regards to studies, but maybe I'm not doing the right searches. Many adaptogens have other functions such as improving cognitive function and stimulating the immune system (could be a good thing or bad thing) and I don't believe all of them even lower cortisol.

    I'm curious though - what's the effect of taking a supplement that lowers cortisol if you already have low cortisol? Does that cause an increase in norepinephrine and/or are there other symptoms? I'm not 100% sure if I even have low cortisol. Last time I was tested was 4 years ago and it was both high and low then. Since my health has gotten worse since then I assumed the natural progression was towards low cortisol, but I don't really know if that's true.
     
  14. jeffrez

    jeffrez Senior Member

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    Hmm, not really convinced, as almost everything in the abstract supports the idea of higher cortisol in MDD! And higher even in those who have remitted from MDD, which I believe is also the usual finding.

    Iow, antidepressant use tended to normalize HPAA functioning, lowering the significantly higher cortisol levels often found in MDD, and then increasing sensitivity of the HPAA to dexamethasone challenge, which would mean the HPAA is functioning more normally.
    Even the conclusion acknowledges association between MDD and higher cortisol, and suggests higher cortisol could indicate a greater predisposition to MDD:
    Curious: how do you read any of that as indicating conflicting data? I'd ask the authors the same thing, as their conclusion doesn't seem to follow their "context" section.
     

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