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Re: Levonorgestrel IUD (LNG-20) and depression » AnneL

Posted by SLS on October 7, 2001, at 9:13:14

In reply to Re: Levonorgestrel IUD (LNG-20) and depression » SLS, posted by AnneL on October 6, 2001, at 23:57:25

> Hi Scott,
>
> It's been a while since I've posted so I guess I forgot how to post. But, anyway, I want to thank you for your response. You've given me some hope.
> I will speak with my Pdoc on Monday about increasing my dose. It makes a lot of sense and hopefully will help me stabilize my moods. If I can get my depression under control this IUD will spare me from a surgery I really don't want. At least not at this time. Would it be logical to assume that if I tolerated a jump from 150 to 225 without any problems (2 months ago - again due to hormonal problems, this time with the Pill) that I
> might do OK going from 225 to 300 mg? What are your thoughts on this? Thanks again, Anne


Hi Anne.

Regarding a dosage increase, all we can say for sure is that we won't know for sure until we know for sure. :-) My guess is that you will tolerate it just fine, especially in light of your previous reaction to it. Some people actually need 600mg. I tolerated 450mg just fine. However, my doctor decided that it provided no more benefit than 300mg. I do lose this benefit when I reduce the dosage to 225mg.

Regarding progestins, I have encountered plenty of stuff in the literature to lead me to believe that they can indeed be depressogenic for some people. In fact, they might even have some potential as anti-manic agents. I have even read some suggestions that progesterone exert mood-stabilizing effects. Estrogen increases the excitability of neurons in certain areas of the brain (I don't remember which), and acts as a mild MAO inhibitor. By contrast, progesterone does exactly the opposite in both regards.

It is my impression that *natural* progesterone is less likely to induce depression than the synthetic progestins. Is there such a thing as equine progesterone? Would using a small amount of systemic estrogen reduce the effectiveness of the IUD? It might offset it with respect to mood.

Anyway, it probably makes sense to first try adjusting the dosage of Effexor.

I'll be crossing my eyes for you.


- Scott

 

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