Posted by ShelliR on April 5, 2001, at 12:34:52
In reply to Re: ML Opiates and Treatment resistant Psychiatrists, posted by Elizabeth on April 5, 2001, at 7:43:53
> > Hi Elizabeth. What is a delta antagonist? Also is buprenorphine "allowed" to be prescribed for depression? Thanks, Shelli
>
> Hi Shelli. There are 3 different types of opioid receptors (that we know of at present, at least), named mu, kappa, and delta (there are also subtypes of these, e.g. mu-1 and mu-2, but let's not get into that). Activation of the mu receptor is responsible for most of the beneficial effects that opioids are known for. Kappa agonists (e.g., Stadol) also have some analgesic action, moreso for women than for men. The delta receptor may also have something to do with relieving pain, but it also seems to be involved in the development of tolerance. Most of the opioids currently marketed for pain are nonselective agonists at all three subtypes. There are a few exceptions, including buprenorphine (Buprenex), butorphanol (stadol), nalbuphine (Nubain), and pentazocine (Talwin).
>
> Buprenorphine is officially labelled for pain, but it's perfectly legal for doctors to prescribe it for off-label uses including depression. (This applies in the U.S., other countries may have different rules.)Thanks Elizabeth for the information. I just went to a new pdoc yesterday and he approved my small amount to hydrocodeine (about 3.75mg per day). He says, however, he cannot prescribe it for me because you can not prescribe it for depression. Right now I am getting it from my gyn for premenstral pain.
When I read what you wrote I wondered if I should be talking about buprenorphine or some other form of opiate with my doctor. However, I don't believe he is much of a specialist in this and I am so grateful to find a pdoc who can accept that I take this, that I don't know if I want to push it any further.
Perhaps along the line it ought to be a neurologist I consult with? It seems the main reason you suggest not using codeine because of the higher risk of addiction which I have not experienced yet, after three years, but of course I cannot rule it out in the future. shelli
poster:ShelliR
thread:57821
URL: http://www.dr-bob.org/babble/20010403/msgs/58798.html