Posted by Lorraine on January 31, 2002, at 10:32:40
In reply to Re: What is buprenorphine like? » MB, posted by Elizabeth on January 30, 2002, at 16:36:21
Elizabeth, it's Lorraine. My pdoc took my pulse last week and told me I had tachycardia and referred me to a heart doctor to wear a halter. I went home and just did some blood pressure and pulse measurements of my own and what I found was that laying down my bp was 107/67 pulse 74, then standing still at three minutes 111/87 pulse 104 and standing still at 10 minutes 116/90 pulse 113--which to me sounds a bit like POTS (postual othostatic tachycardia syndrome). My pdoc thinks that I may be randomly throwing out NE to generate the tachycardia--though I think there is a standing, sitting, laying, walking component to it as well. Have you ever heard of such a thing? For a long time, two of my primary complaints have been fatigue and anxiety. Anyway, I did try a beta blocker sometime back (propanolol) which made things worse in terms of fatigue.
It has all made me wonder, whether I have adequately "ruled out" physical problems that may be contributing (or causing or interfering with treatment success by causing side effects etc). I have never had a thorough "work-up", neurological or otherwise. Though I have been told that I have some brain lesions and that my alpha waves are low. I'm thinking of getting a full neurological work-up, MRI of head and neck area and so forth. Do you have any thoughts you'd be will to share with me on this? I so value your input.
Thank-you.
Lorraine
> > One time in detox (heroin) I was given buprenorphin sublingually to ease the withdrawal. I wasn't too impressed with it.
>
> How much were they giving you? The sublingual dose needs to be rather high, I think, especially for addicts and especially if you're using the injectable solution marketed in the U.S. Some addicts say it really helps them to detox and others don't, so you're not alone.
>
> > It didn't seem to help much, but then again, there was no way of telling how bad I would have felt if I *hadn't* been givin that accepably palatable liquid to suck on.
>
> It's in a 5% dextrose solution (a type of sugar), hence the funky-sweet taste. How long did they tell you to keep it in your mouth?
>
> > For all I know, it was a godsend, but my intuition tells me that I wouldn't have been much worse off without it.
>
> Have you ever experienced heroin withdrawal without buprenorphine?
>
> I'd expect buprenorphine to do more for you if you took it outside the context of opioid dependence (i.e., when you hadn't taken heroin for a while and so did not have any tolerance).
>
> BTW, when the doctor in the hospital gave you the IM injection, do you know what the dose was?
>
> > My limited and extremely adulterated experience with buprenorphine compels me to ask this question: what is the medication like under normal circumstances--i.e., circumstamnce where the patient is neither habituated to opoid agonists nor in a state of withdrawal from such agonists.
>
> (Right, that's what I meant. You expressed it a lot better.)
>
> > Is is sedating?
>
> For some people. It seems that there are people who experience paradoxical stimulation on opioids (like myself), though. My experience is that every opioid I've tried has been activating, not just buprenorphine. I think sedation is more common. I don't know if the paradoxical response is predictive of antidepressant response.
>
> > Is it nauseating?
>
> Yeah, you have to be cautious about the dose.
>
> > Dysphoria, euphoria, etc.
>
> Neither, but a feeling of calm and "wellness." (Again, there's a subset of people who get dysphoric on opioids; these people will probably feel dysphoric on buprenorphine too, but this is a general reaction to mu agonists, not a specific reaction to buprenorphine.) I also find that it clears up "brain fog."
>
> > Is there a waiting period before antidepressant effects are noticed, or is relief immediate as with the pure agonists?
>
> It takes about an hour when administered intranasally, IME. Presumable it's faster when given IM.
>
> > I've taken butorphanol before. That was weird. A lot of kappa agonism I think. Is buprenorphine anything like butorphanol?
>
> Its pharmacological profile is opposite that of Stadol (butorphanol) -- buprenorphine is a kappa antagonist, partial mu agonist. I've never taken Stadol so I can't really say anything about how they compare.
>
> HTH
>
> -elizabeth
poster:Lorraine
thread:91813
URL: http://www.dr-bob.org/babble/20020131/msgs/92359.html