Posted by BrittPark on October 23, 2002, at 16:53:36
In reply to i have an appt w/ Dr. Stoll please help anyone, posted by reese1 on October 23, 2002, at 14:17:59
Just tell Dr. Stoll that in the past you have usually required larger doses of medication than average. It's quite probable that you're a hyper-metabolizer. I am. I need to take 300mg imipramine a day to get a blood level in the middle of the therapeutic range.
Now, Dr. Stoll may still wish to start you on a low dose but if he's really used to working with opiates he'll be willing to increase dosages as needed.
If you get a chance ask him if he's heard of the combination of an opioid agonist, like oxycontin, in combination with a super low dose of naltrexone (perhaps 100 micrograms). There has been research done that shows that such a combination potentiates the action of the opioid and inhibits the development of tolerance which is of course the chief difficulty with opioid therapy. There's a company called Pain Therapeutics which is developing just such combination drugs. I think they are in stage III trials.
I think opioids are the great undiscovered country for the treatment of depression.
My apologies for ranting.
The most important thing is that you get effective treatment. Best of luck, though you shouldn't need it because you will find something that works.
Feel Better,
Britt
poster:BrittPark
thread:4588
URL: http://www.dr-bob.org/babble/20021019/msgs/124898.html