Posted by Elizabeth on April 4, 2001, at 16:59:11
In reply to Balancing the opoid and Serotonin systems, posted by Fred Potter on April 3, 2001, at 18:46:36
> Even the title shows I don't know what I'm talking about. Elizabeth said Naltrexone wasn't a "good-feeling" drug. For pooped-out Prozac I found it made me feel marvellous (normal?) in about 3 days, and this was sustained until I ran out of money.
>
> Can anyone explain the TIPS remark that imbalance between these systems can cause treatment resistant depression? How does clogging up opoid receptor sites, thus blocking my own endorphins, make me feel good?I don't know why naltrexone might work, but *very* small amounts have been shown to attenuate morphine tolerance (probably owing to antagonism at the delta opioid receptor). Perhaps your use for naltrexone (to reverse Prozac tolerance) is related. (What I've heard about the effects of naltrexone on mood only pertains to its use by itself.)
> Is Bupenorphrine effective in the same way as Naltrexone? In which case is it cheaper? I can't afford Naltrexone. Does Bupe also curb cravings for drink? Nalt did it so well, even at half the proper dose.
Buprenorphine works more like an agonist (e.g., morphine) than like naltrexone. It may help you, but not in the same way as naltrexone did. (I am pretty sure that, if buprenorphine did help, it would be independent of the Prozac.) It's very effective for blocking opioid cravings, and some research exists suggesting that it can block cravings for other drugs as well. (I may be misremembering, but my recollection is that the data on buprenorphine for alcoholism are promising but limited to rodents.)
Sal's idea of Buspar and pindolol is a good one; the combination is novel, but existing research is promising. I don't know what else you've tried, but going off the Prozac for a few weeks (perhaps substituting another AD with a different mechanism) and then starting it again might work. Switching to a different SSRI is also an option (my pdoc says this often works in situations like yours). Another type of AD may work, as well.
I'd like to hear what you decide to do and whether it works for you. Best of luck.
poster:Elizabeth
thread:58581
URL: http://www.dr-bob.org/babble/20010403/msgs/58693.html