Posted by mike21 on April 13, 2002, at 8:55:13
In reply to Re: opioids (and benzos?) » Elizabeth, posted by mike21 on April 12, 2002, at 19:39:30
> > > I can't find the previous thread where we discussed this, but, you mentioned side-effects with taking opioid agonists. I was thinking that if I truly had an opioid deficiency, side-effects would be minimal or none. Maybe that's not realistic.
> >
> > I don't think it is. The "deficiency," whatever it is, would be central but not necessarily peripheral, for one thing; a lot of the side effects are not centrally mediated (for example, there are a lot of opioid receptors in the gut). Also, and probably more importantly, "deficiency" shouldn't necessarily be taken to mean low levels of endogenous opioids; a number of other things could be responsible for a "deficient" endogenous opioid system (probably including some that nobody even knows about at present).
> >
> > > In your experience with Dr. Bodkin, did you get the impression he had treated many patients successfully with long-term use of buprenorphine?
> >
> > I saw him in 1996, only shortly after he'd published the results of the study; I'm not sure whether he had used it other times, but he seemed fairly impressed by it. (I met with him again in 1998, but we didn't discuss buprenorphine.) But there are quite a few pdocs who report cases of treating people long-term for depression with buprenorphine and other opioids.
> >
> > So -- what about benzos???
> >
> > -elizabeth
>
> Benzos have been great for me. I was on valium, 10-20mg/day for a year. It changed my life. I started having a social life, dating some, had a friend I hung out with, started doing some things I think normal people do in their lives. That was my senior year in college.
>
> Then I graduated, got a job, and decided I had to get off the valium. It was just for temporary anxiety anyway. I was mature enough and in control of my emotions, etc., to not need it anymore. Weened myself off it, no problem. Felt like I no longer experienced pleasure the same, though I never experienced it that great to begin with. Maybe it was the drug, maybe I was just getting older.
>
> I drank a lot in college. I can't recover from the withdrawal from alcohol anymore, either.
>
> Being on a drug that long just makes me really want it to be the right thing. I don't want to make things worse than they already are. I don't want to take the wrong drug, develop "dependency" or whatever you want to call it, then need it for the rest of my life. In short, I want to treat specifically what it is that ails me (don't we all).
>
> Like I've said before, I've never heard of anyone having a benzodiazepine deficiency.
>
> I am resigning myself to the idea that I will need to be on a medication of some sort for the rest of my life if there is any hope of fitting in to this culture and being normal. By being normal, I mean having human relationships, experiencing playfulness, enjoying social interaction enough to involve myself intimately with another person long-term. I am in my mid-20s and the longest romantic relationship I've had was 2 months.
>
> BTW, I saw my pdoc today. I had been on a wellbutrin trial that did exactly what I don't want done- more obsessing, less sleep, anxiety, agitation. I stuck with it for two weeks. I am not going to torture/damage myself just because it might theoretically work eventually to do something.
>
> He put me on imipramine. I guess I have to exhaust all the old stand-bys before I could do anything exotic like buprenorphine. Not like he would ever put me on that. He had never heard of it. I left him some reading material on it though. I don't think he's going to read it.
>
> Imipramine, being a TCA, works like reuptake inhibitors, right? I asked him that, because I've had it with SSRIs, but he said it was different and mentioned something about dopamine. I asked if it was like mirapex or dexedrine and he said no. I have to find out more about it before I decide if I will try it.
>
> I am on Klonopin now, 1mg. It has been working. Maybe benzos alter sleep architecture, but mine was pretty lousy to begin with. 6 hours a night, then I would struggle to get back to sleep. Now if I wake up I easily go back to sleep. There is some daytime sedation though. I still think I concentrate better on work tasks than without it. I am able to be more spontaneous now and react quicker in social situations. Isn't that ironic, a tranquilizer would actually make someone seem mentally quicker?
>
> In short, it helps me in some ways, but is it the answer? I don't know.
>
> That's the story with benzos.
>
> MikeI have done some reading on imipramine since my last post. Yes, it inhibits reuptake of serotonin and norepinephrine. It also has a reputation for harming intellectual performance. This reuptake model for treating depression does not seem to work for me. My doc doesn't seem to get it. TCAs are also anti-histamines which I have adverse reactions to- increase anxiety, lack of mental sharpness. I told my doc that when he prescribed the remeron (in conjunction with wellbutrin, much to my chagrin... too much NE action). I am frustrated now.
Mike
poster:mike21
thread:102601
URL: http://www.dr-bob.org/babble/20020408/msgs/102946.html