Low Cholesterol & Depression
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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 confirmed
Hyyppa (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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