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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 25 of 29. This is the beginning of the thread.
Posted by MB on July 13, 2002, at 15:13:06
OK, I've been talking it over with family members, and I'm pretty convinced that my depression started when I took Accutane for cystic acne in the mid-eighties before the warnings (actually, I had to complete three "treatment courses," each separated by a few months, before the results were adequate). Does anybody know if if there are treatments that are more successful in treating Accutane induced depression than others (e.g., would one class of med be better than another, etc).
Just curious,
MB
Posted by Shawn. T. on July 13, 2002, at 16:03:31
In reply to Accutane induced depression...different treatment?, posted by MB on July 13, 2002, at 15:13:06
Some various journal reports on Accutane induced depression:
http://www4.infotrieve.com/search/databases/results.asp?presearch=1&dbname=M&query=%28Isotretinoin%29+and+depressionBased on this
http://www4.infotrieve.com/search/databases/detailsNew.asp?artID=17856575I guessed collegenase has something to do with acne. See the left bar on the first page of
http://www.cop.ufl.edu/vdis/bulletin/0199.PDFSo collegenase reduction increases collagen.
Perhaps the reduction of collegenase is more marked than the reduction of collagen with Accutane?On collagen and acne:
http://www4.infotrieve.com/search/databases/detailsNew.asp?artID=698545
Some more information (I fear that Accutane may affect enzymes which break down cholesterol and adrenal hormones):
http://www4.infotrieve.com/search/databases/detailsNew.asp?artID=26457130For a potentially more effective treatment of acne, see
http://www.biospecifics.com/collagenase_why.htmlAs for treatment, I strongly suggest that you see a doctor about getting every single one of your adrenal hormone levels checked out. Too much or too little of any of these hormones will point to potentially effective treatments. I am also guessing that your HPA axis is disregulated; mention that to your doctor.
Posted by MB on July 13, 2002, at 16:11:20
In reply to Re: Accutane induced depression...different treatment?, posted by Shawn. T. on July 13, 2002, at 16:03:31
WOW, thanks for all the info and links. I will start reading them asap.
Peace,
MB
> Some various journal reports on Accutane induced depression:
> http://www4.infotrieve.com/search/databases/results.asp?presearch=1&dbname=M&query=%28Isotretinoin%29+and+depression
>
> Based on this
> http://www4.infotrieve.com/search/databases/detailsNew.asp?artID=17856575
>
> I guessed collegenase has something to do with acne. See the left bar on the first page of
> http://www.cop.ufl.edu/vdis/bulletin/0199.PDF
>
> So collegenase reduction increases collagen.
> Perhaps the reduction of collegenase is more marked than the reduction of collagen with Accutane?
>
> On collagen and acne:
> http://www4.infotrieve.com/search/databases/detailsNew.asp?artID=698545
>
>
> Some more information (I fear that Accutane may affect enzymes which break down cholesterol and adrenal hormones):
> http://www4.infotrieve.com/search/databases/detailsNew.asp?artID=26457130
>
> For a potentially more effective treatment of acne, see
> http://www.biospecifics.com/collagenase_why.html
>
> As for treatment, I strongly suggest that you see a doctor about getting every single one of your adrenal hormone levels checked out. Too much or too little of any of these hormones will point to potentially effective treatments. I am also guessing that your HPA axis is disregulated; mention that to your doctor.
Posted by Shawn. T. on July 13, 2002, at 16:42:45
In reply to Re: Accutane induced depression...different treatment? » Shawn. T., posted by MB on July 13, 2002, at 16:11:20
You're welcome.
Shawn
Posted by jsarirose on July 16, 2002, at 14:49:44
In reply to Re: Accutane induced depression...different treatment?, posted by Shawn. T. on July 13, 2002, at 16:42:45
What do you think about acne caused by anti-depressents? Parnate seems to have greatly aggravated my depression. I've run the gamut of most acne meds and am thinking about gambling with Accutane again. I took it once about 14 years ago and it worked great. I have long-term depression since I was around 8 - about 26 years now. I'm getting some relief from my current med, but I'd like to get rid of the severe acne.
Do you think Accutane could still cause depression if I've taken it before with no ill effect? What are the general odds of a depressive episode?
Thanks,
Jessica
Posted by Shawn. T. on July 16, 2002, at 16:11:59
In reply to Re: Accutane induced depression...different treatment?, posted by jsarirose on July 16, 2002, at 14:49:44
Antidepressants like Parnate increase monoamine levels (serotonin, dopamine, and noradrenaline aka norepinephrine). I would guess that noradrenaline is the monoamine that would have the most effect on acne. I reccommend finding an acne med that is said to inhibit the activity of collagenase only. Buy a facial cream that contains collagen and whatever else you like.
Shawn
> What do you think about acne caused by anti-depressents? Parnate seems to have greatly aggravated my depression. I've run the gamut of most acne meds and am thinking about gambling with Accutane again. I took it once about 14 years ago and it worked great. I have long-term depression since I was around 8 - about 26 years now. I'm getting some relief from my current med, but I'd like to get rid of the severe acne.
>
> Do you think Accutane could still cause depression if I've taken it before with no ill effect? What are the general odds of a depressive episode?
>
> Thanks,
> Jessica
Posted by Seamus2 on July 16, 2002, at 21:20:18
In reply to Re: Accutane induced depression...different treatment?, posted by jsarirose on July 16, 2002, at 14:49:44
>>Parnate seems to have greatly aggravated my depression.<<
It's not supposed to do that, you know.
Especially at 100 mg/day!
Have you given good old-fashioned Retin-A a fair trial for at least two months? It makes acne worse at first, but once that clears up it works well.
Then there's the matter of getting the proper strength. In my experience, you want once a day dosing after a morning shower, and at a strength which is enough for your friends to say "My, you've been getting some sun!" but NOT enough to cause outright peeling. I use 0.5% cream and have for years; but it would be okay to mix equal amounts of 0.1 and 0.5 if that's what it takes.
Damn stuff should be OTC. A 45 gm tube costs $85.00...
Seamus
Posted by jsarirose on July 16, 2002, at 21:29:34
In reply to Re: Accutane induced depression...different treatment?, posted by Seamus2 on July 16, 2002, at 21:20:18
> >>Parnate seems to have greatly aggravated my depression.<<
>
> It's not supposed to do that, you know.
>
> Especially at 100 mg/day!
>
> Have you given good old-fashioned Retin-A a fair trial for at least two months? It makes acne worse at first, but once that clears up it works well.
>
> Then there's the matter of getting the proper strength. In my experience, you want once a day dosing after a morning shower, and at a strength which is enough for your friends to say "My, you've been getting some sun!" but NOT enough to cause outright peeling. I use 0.5% cream and have for years; but it would be okay to mix equal amounts of 0.1 and 0.5 if that's what it takes.
>
> Damn stuff should be OTC. A 45 gm tube costs $85.00...
>
> Seamus
(Oops, I meant aggravate my ACNE, not depression - but you figured that out.)
I used Retin-A years ago when I had bad acne, I don't know why the dermatologist hasn't tried it again. I guess he keeps saying it's cystic acne and topical things will help but not take care of the problem. I was on a stronger antibiotic which helped but it made me too nauseous. I'll ask about Retin-A again.
-Jessica
Posted by cybercafe on July 17, 2002, at 1:44:55
In reply to Re: Accutane induced depression...different treatment?, posted by jsarirose on July 16, 2002, at 21:29:34
whats cystic acne? ... you mean those hard growths that come from blocked sebum glands??
Posted by jsarirose on July 17, 2002, at 14:29:43
In reply to Re: Accutane induced depression...different treatment?, posted by cybercafe on July 17, 2002, at 1:44:55
>
> whats cystic acne? ... you mean those hard growths that come from blocked sebum glands??I think it's basically acne that comes from an internal problem more than external. The topical creams and medicines will help with the symptom (acne) but not the cause (the acne will still be created). Some acne is easier to cure than others, mine tends to be very treatment-resistant (as I seem to be in most things). I believe it's cause primarily by the Parnate I'm taking. And also partly from having PCOS (Poly-cystic Ovarian Syndrome caused by a hormonal imbalance).
-Jessica
Posted by Seamus2 on July 17, 2002, at 19:41:51
In reply to Re: Accutane induced depression...different treatment?, posted by jsarirose on July 17, 2002, at 14:29:43
Hey, I forgot to mention BactroBan for cystic acne.
It's a odd antibiotic used intranasally for a week to kill off staph bacteria residing therein. (a supposed "reservoir" of infection)
I had a bad spate of boils a while back and my doc suggested it. *Something* stopped their proliferation, but I can't conclusively say it was the BactroBan.
On another note, a friend in India has been asked to join a research project investigating the use of lamotrigine in PCOS. I'll ask if he knows the rationale when I speak with him next.
Seamus
Posted by jsarirose on July 18, 2002, at 1:06:44
In reply to Re: Accutane induced depression... PCOS » jsarirose, posted by Seamus2 on July 17, 2002, at 19:41:51
> Hey, I forgot to mention BactroBan for cystic acne.
>
> It's a odd antibiotic used intranasally for a week to kill off staph bacteria residing therein. (a supposed "reservoir" of infection)
>
> I had a bad spate of boils a while back and my doc suggested it. *Something* stopped their proliferation, but I can't conclusively say it was the BactroBan.
>
> On another note, a friend in India has been asked to join a research project investigating the use of lamotrigine in PCOS. I'll ask if he knows the rationale when I speak with him next.
>
> SeamusCool - I have an appointment coming up and I'll have to mention it to my dermatologist. I've heard of lamotrigine, but I can't think in what context. I'd be very interested in what they're studying abroad.
Thanks,
Jessica
Posted by cybercafe on July 18, 2002, at 13:25:36
In reply to Re: Accutane induced depression...different treatment?, posted by jsarirose on July 17, 2002, at 14:29:43
> I think it's basically acne that comes from an internal problem more than external. The topical creams and medicines will help with the symptom
Hey Jessica hope you're doing with the lamictal :)
... i am getting annoyed that this one cyst won't go away - mostly because i find parnate causes a bit of agitation :( - and i too have wondered if it is related to hormones or something...
.. i think i read that thyroid levels are somewhat unusual (though still within the normal range??) in bipolar and treatment resistant depressives... so i often wondered if taking a thyroid hormone might cure me... (and get rid of the cyst??) ...
... but i've only read one or two sites so don't take what i say on the matter too seriously :)
... oh have you ever tried T3 or T4 btw?
Posted by jsarirose on July 18, 2002, at 14:00:48
In reply to Re: Accutane induced depression...different treatment?, posted by cybercafe on July 18, 2002, at 13:25:36
> > I think it's basically acne that comes from an internal problem more than external. The topical creams and medicines will help with the symptom
>
> Hey Jessica hope you're doing with the lamictal :)
>
> ... i am getting annoyed that this one cyst won't go away - mostly because i find parnate causes a bit of agitation :( - and i too have wondered if it is related to hormones or something...
>
> .. i think i read that thyroid levels are somewhat unusual (though still within the normal range??) in bipolar and treatment resistant depressives... so i often wondered if taking a thyroid hormone might cure me... (and get rid of the cyst??) ...
>
> ... but i've only read one or two sites so don't take what i say on the matter too seriously :)
>
> ... oh have you ever tried T3 or T4 btw?Well, actually I have! (It sometimes seems like there isn't much I haven't tried.) Years ago my pdoc tested me for low thyroid. To my surprise it came back positive (for low). I started on a low dose and personally didn't notice any difference (although low thyroid can cause tireness and depression). Every year or so she would test it and up my dose. The last time she tested it she upped it to 0.1 from .075. I started losing my hair, my scalp got really dandruffy and changed texture no matter how often I washed it and with what. I found out that this can be caused by thyroid meds. I went back down to .075 and I've been fine ever since (hair & scalp-wise). It does take a month or more for either symptom to kick in. My thyroid has always been borderline so I've always been a little concerned with taking it when it's not necessary.
I do encourage you to get your TSH levels checked though. It doesn't hurt and if you're borderline you could start with a low dose.
-Jessica
Posted by cybercafe on July 19, 2002, at 2:21:42
In reply to Re: Accutane induced depression...different treatment? » cybercafe, posted by jsarirose on July 18, 2002, at 14:00:48
>she tested it she upped it to 0.1 from .075. I started losing my hair, my scalp got really dandruffy and changed texture no matter how often either symptom to kick in. My thyroid has always been borderline so I've always been a little concerned with taking it when it's not necessary.
you're still taking it are you? ... so does that mean it had some benefit for you ?
> I do encourage you to get your TSH levels checked though. It doesn't hurt and if you're borderline you could start with a low dose.it's strange because i actually suffer from all of the symptoms of hypothyroidism
unusually dry skin
feeling cold all the time
constipation
wounds take forever to heal
dry hair... but my thyroid level is normal high -
TSH = 1.42.... strangely, most of my symptoms are in remission -- a lot are worse in the winter ... but i am wondering if the parnate might be rising my thyroid?
Posted by jsarirose on July 19, 2002, at 3:39:06
In reply to thyroid? , posted by cybercafe on July 19, 2002, at 2:21:42
> >she tested it she upped it to 0.1 from .075. I started losing my hair, my scalp got really dandruffy and changed texture no matter how often either symptom to kick in. My thyroid has always been borderline so I've always been a little concerned with taking it when it's not necessary.
>
> you're still taking it are you? ... so does that mean it had some benefit for you ?
>
>
> > I do encourage you to get your TSH levels checked though. It doesn't hurt and if you're borderline you could start with a low dose.
>
> it's strange because i actually suffer from all of the symptoms of hypothyroidism
>
> unusually dry skin
> feeling cold all the time
> constipation
> wounds take forever to heal
> dry hair
>
> ... but my thyroid level is normal high -
> TSH = 1.42
>
> .... strangely, most of my symptoms are in remission -- a lot are worse in the winter ... but i am wondering if the parnate might be rising my thyroid?Actually, I never noticed any difference no matter what dose I was on. I also always had severe depression at the time though. I've stayed on it only because according to my tests it was borderline low. I thought 2-4 was normal, if so, you would also be slightly on the low side. But I might be wrong.
I never did have any of the symptoms you mention other than being tired and having depression, which I think was more depression than anything else. It was only when I took too much that I started getting the adverse reaction (scalp, hair, etc.).
And, as far as I know, Parnate doesn't effect thyroid. I even asked my doctor about it because my hair was falling out and I was on both the increased thyroid med and Parnate. Parnate shouldn't have any effect. And I did test normal (2.50) the last test I did taking .075 thyroid (Levoxl) and 100mg Parnate.
Here's a great page on it (sounds like you have a lot of the symptoms): http://www.mercola.com/article/hypothyroid/diagnosis_comp.htm
-Jessica
Posted by jsarirose on July 19, 2002, at 3:42:04
In reply to Re: thyroid? » cybercafe, posted by jsarirose on July 19, 2002, at 3:39:06
I just found some more information. If your level is 1.4 then it's probably low and you might have hyperthyroidism (not hypo). Here's another page with the symptoms you mention and they relate it to overactive thyroid.
http://my.webmd.com/encyclopedia/article/4118.242#hw28659
That probably explains why I never had the same symptoms as you.
-Jessica
Posted by cybercafe on July 20, 2002, at 5:07:59
In reply to Re: thyroid? (another thought), posted by jsarirose on July 19, 2002, at 3:42:04
I dunno jess... I really appreciate you sending me the link, as I now realize I may (or may not) have secondary hypothyroidism ...... i have often wondered if the problem may not be in your hypothalamus not secreting enough TSH rather than it being in your thyroid not properly responding to the TSH secreted
... i also wonder if it is possible to have intermittant thyroidism ... sometimes hypo, sometimes hyper....
oh well ... it sucks when your brain don't work :)
> I just found some more information. If your level is 1.4 then it's probably low and you might have hyperthyroidism (not hypo). Here's another page with the symptoms you mention and they relate it to overactive thyroid.
Posted by cybercafe on July 20, 2002, at 6:56:27
In reply to Re: thyroid? (another thought), posted by jsarirose on July 19, 2002, at 3:42:04
you know what? i remember you saying that you were told MAOIs don't influence thyroid, however, i am left wondering how they can not given that:1. dopamine is known to influence thyroid levels
2. the pituitary controls the release of TSH
3. dopamine acts on D2 receptors in the pituitary to control prolactin release = testosterone levels = libido
4. as we all know, Parnate definately affects libido :)so basically i am left wondering if there is another non-hormonal means through which parnate affects libido (perhaps NE A2 receptor)
Posted by jsarirose on July 20, 2002, at 14:16:44
In reply to Re: thyroid? (another thought) jrosen, posted by cybercafe on July 20, 2002, at 6:56:27
Well, I absolutely don't take any doctor's word as god anymore! : ) Especially after calling in and having the doctor on call tell me there is absolutely no evidence of Celexa causing withdrawal. (My regular doctor was also not aware of Celexa withdrawal.) He said I was either imagining the symptoms or it's from something else. Of course, after checking the web - it's extremely common!
So, it's entirely possible I'm wrong! That's just what I was told about thyroid. I tend to believe what I read on the net and multiple personal experiences more than what my doctor says on most things.
-Jessica
Posted by GW on September 29, 2003, at 23:42:13
In reply to Re: Accutane induced depression...different treatment?, posted by jsarirose on July 16, 2002, at 21:29:34
Who would have known a Google search for "Accutane PolyCystic Ovarian Syndrome" would lead to here? My dermatologist has written a prescription for Accutane to treat my cystic acne, but I'm wary after reading about the side effects in the booklet he passed to me. Moreover, it may not clear up my acne as well, compared to patients without PCOS. Any thoughts? Thanks,
GW
Posted by Ilene on October 1, 2003, at 23:49:19
In reply to Re: Accutane induced depression...different treatment?, posted by GW on September 29, 2003, at 23:42:13
> Who would have known a Google search for "Accutane PolyCystic Ovarian Syndrome" would lead to here? My dermatologist has written a prescription for Accutane to treat my cystic acne, but I'm wary after reading about the side effects in the booklet he passed to me. Moreover, it may not clear up my acne as well, compared to patients without PCOS. Any thoughts? Thanks,
> GWI took Accutane about 10 years ago, before it was connected to depression (otherwise I would never have taken it). It is a powerful drug but it did not make me depressed. I still have some acne, but not nearly as badly as before . My skin became very dry, but that didn't last either.
As far as PCOS--I never had any fertility problems even though I have other symptoms of PCOS. I think the diagnosis can be fuzzy, depending on your doctor.
I would take it over again.
Ilene
Posted by jsarirose on October 2, 2003, at 0:22:51
In reply to Re: Accutane induced depression...different treatm » GW, posted by Ilene on October 1, 2003, at 23:49:19
> I took Accutane about 10 years ago, before it was connected to depression (otherwise I would never have taken it). It is a powerful drug but it did not make me depressed. I still have some acne, but not nearly as badly as before . My skin became very dry, but that didn't last either.
>
> As far as PCOS--I never had any fertility problems even though I have other symptoms of PCOS. I think the diagnosis can be fuzzy, depending on your doctor.
>
> I would take it over again.
>
> Ilene
>You sound just like me! I took it about 15 years ago and it did wonders for my skin. I was diagnosed much later with PCOS (but always had the symptoms). I also have depression which started before the Accutane and continued afterward.
-Jessica
Posted by Ilene on October 2, 2003, at 7:50:14
In reply to Re: Accutane induced depression...different treatm, posted by jsarirose on October 2, 2003, at 0:22:51
> You sound just like me! I took it about 15 years ago and it did wonders for my skin. I was diagnosed much later with PCOS (but always had the symptoms). I also have depression which started before the Accutane and continued afterward.
>
> -JessicaIs there any kind of treatment for PCOS, and is it related to your depression?
Ilene
Posted by phoeb on October 2, 2003, at 10:08:38
In reply to Re: Accutane induced depression...different treatment?, posted by GW on September 29, 2003, at 23:42:13
I wonder if any of you have this pattern of depression or something similar. I feel like a freak of nature because i've never heard of it. Anyway, I cycle every three weeks between total normalcy and suicadal, terror filled black hole that lasts between one and two weeks. I'm not considered bipolar because i never have mania or hypomania, and i don't understand this cyclical thing. It's not even tied to my menstrual cycle. By the way, I'm on Nardil 105 mg, Lamictal 200, and lorazepam and xyprexa as needed. Any similar experiences? What were you on? Has the cycle gottn any better? PLease Please let me kmnow.
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