Posted by Elizabeth on October 22, 2001, at 11:43:48
In reply to Re: opiates and major depression, posted by androog on October 19, 2001, at 23:26:35
> It's just a guess, but I'd say a good majority of substance abusers are suffering from some form of depression.
Me too; depression or anxiety, anyway. A *lot* of opioid addicts have major social anxiety, which I very much identify with. One guy said that when he's around lots of people, he feels like they look like gargoyles. And I knew what he meant (although he said it much more concisely and more clearly than I ever could).
> I know all the talk is about serotonin, but I'd bet the house that what we substance abusers are lacking in are endorphins.
I suspect it's a little more complicated than that, but yes, the endogenous opioid system is undoubtably involved in our problems. (I'm not an addict, but I think that my troubles aren't all that different from those of many -- most? -- opioid addicts, and perhaps alcoholics too.)
> Anyway, I just got a call back from the one doc I'd called earlier who sounded as though he might be willing to give the tramadol a try. In his return call he said he couldn't find enough evidence to back up my claim that opiates have been successfully used in the treatment of depression. I found this odd because it took me only a few minutes on the internet to find a study conducted by the Harvard School of Medicine that supported my claim.
A lot of the research on the subject seems to come out of Harvard, yes. Take a look at http://www.hmcnet.harvard.edu/psych/redbook/15.htm
Here are some other sites and cites:
http://www.addict.f2s.com/medarticlemenu.html
"An Addict's View -- Medical Articles." Great site. A selection of research (basic and clinical) articles relating to opioids and psych disorders.Stoll AL, Rueter S. Treatment augmentation with opiates in severe and refractory major depression. Am J Psychiatry. 1999 Dec;156(12):2017.
A clinical case series in which oxycodone and (get this) oxymorphone were used successfully as antidepressants for patients who hadn't responded to conventional treatments.Bodkin JA, Zornberg GL, Lukas SE, Cole JO. Buprenorphine treatment of refractory depression.
J Clin Psychopharmacol. 1995 Feb;15(1):49-57.
Another case series, this one using buprenorphine. You can read this one on the web: http://balder.prohosting.com/~adhpage/bupe.htmlCallaway E. Buprenorphine for depression: the un-adoptable orphan. Biol Psychiatry. 1996 Jun 15;39(12):989-90.
And here's some stuff on Ultram (some pro, some anti):
Shapira NA, Verduin ML, DeGraw JD. Treatment of refractory major depression with tramadol monotherapy. J Clin Psychiatry. 2001 Mar;62(3):205-6.
Goldsmith TB, Shapira NA, Keck PE Jr. Rapid remission of OCD with tramadol hydrochloride. Am J Psychiatry. 1999 Apr;156(4):660-1.
Spencer C. The efficacy of intramuscular tramadol as a rapid-onset antidepressant. Aust N Z J Psychiatry. 2000 Dec;34(6):1032-3.
Halfpenny DM, Callado LF, Stamford JA. Is tramadol an antidepressant? Br J Anaesth. 1999 Mar;82(3):480-1.
Markowitz JS, Patrick KS. Venlafaxine-tramadol similarities. Med Hypotheses. 1998 Aug;51(2):167-8.
Rojas-Corrales MO, Gibert-Rahola J, Mico JA. Tramadol induces antidepressant-type effects in mice. Life Sci. 1998;63(12):PL175-80.
I know there's been an article or letter somewhere that describes a case of Ultram treatment of social phobia (it might be the OCD one).
HTH
-elizabeth
poster:Elizabeth
thread:81414
URL: http://www.dr-bob.org/babble/20011015/msgs/81971.html