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Q: Low Cholesterol & Depression
I had a recnt breakthrough depression after 17 years of being
depression free on a regimen of lithium and thyroxine (T4). I increased my
lithium level from 0.6 to 1.0(with no side effects} and dropped my T4 some and
added T3. The depression has adequately but not yet entirely resolved.
During this time frame while on Lipitor and omega 3 fatty acids (used for
cardiovascular effect, not as a mood stabilizer) my cholesterol fell from 177 to
125. Could the low cholesterol be contributory to the depression?
Hello Mr. B' --
That is a great question. Maybe you heard about how when the medications
used for cholesterol before lipitor ("resins" like cholestiramine)
were first being studied, in about the first 3 major studies the heart attack
rate went down but the "violent death" rate went up, and there were
suspicions that suicide was part of that increase. This idea has never
quite disappeared. In fact, it's being studied directly, and the question
is no longer "if", but rather "how"? The most recent
study I could find was looking at steroid hormones as some sort of intermediary
but that hypothesis was not confirmedHyyppa
(if you wanted more references, you could get that paper and then follow
the references from the introduction).
Pardon me but I have to wonder out loud about how
Lipitor got in the picture if the starting cholesterol was 177? Or was it
that the Lipitor was in there for a much higher level of cholesterol at one
time, and working well (i.e. producing a level of 177), before the
depression?
You can see how that prompts the question, which surely
you've wondered about as well, as to whether the opposite question from the one
you asked is also relevant: could the depression lower your cholesterol
level? (if I'm reading you right, it sounds like that's what happened? or
maybe there aren't enough cholesterol values to tell the chicken from the egg?)
Interesting, certainly. We haven't even looked at
the role of the Omega 3's, either. They are supposed to act like lithium,
as you know, but there is one case of hypomania seemingly associated with them,
so they are not entirely "clean" in terms of their mood effects
either. Complicated, isn't it?
Dr. Phelps
Published April, 2003
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