Posted by BrittPark on November 5, 2002, at 16:17:56
In reply to Re: Can I ask about methadone here?all, posted by lostsailor on November 5, 2002, at 14:43:20
There are lots of different opioids ;) Only two have been studied for the treatment of depression in recent years: buprenorphine and tramadol. There are a (small) number of psychiatrists who use opiods in treatment. I've heard of oxycodone, vicodin, even morphine being used. My psychiatrist was unaware of the use of opioids in depression, and he's considered to be one of the best psychopharmacologists in the S.F. bay area.
<rant not directed at anyone>
Historically however opioids have been used to treat depression. Before the rise of antidepressants there were 4 medical treatments for depression, opiates, stimulants, Shock treatments, and insulin shock treatment, the last two rather unpleasant. Opiates and Stimulants were both effective but naturally enough usually pooped out quickly.
The real shame is that essentially no research is being done on opioids in psychiatry. Given a political climate that gives us a "war on drugs" it's not surprising that grant proposals for antidepressant use of opioids are unlikely to be funded.From a scientific point of view this is ridiculous. Endogenous opioids are clearly implicated not only in pain perception but in regulation of mood. To ignore a whole branch of neurochemistry in the search for treatments for mental illnesses is scandalous. The logic seems to be along the lines of "If insulin got non-diabetics high, there would be no research into diabetes."
There was an antidepressant marketed in Europe called amineptine (the one and only selective dopamine reuptake inhibitor). Not only did the FDA not approve it for the USA but it used its political muscle to force European countries to remove amineptine from the market. Why? Because amineptine had the unwanted side-effect of making "normal" people feel better.
I note also that in the 50 years or so since the first antidepressants were discovered, no new antidepressant has been found to be better than those that have gone before. Yes their side-effect profiles have gotten better, but the efficacy of all antidepressants is statistically the same. Could it be the narrow focus on NE and Serotonin systems at the expense of dopamine, opioid, cannabinoid systems?
</rant>Everbody feel better (by whatever means),
Britt
poster:BrittPark
thread:125715
URL: http://www.dr-bob.org/babble/20021101/msgs/126556.html