Posted by temoigneur on September 25, 2003, at 17:54:14
In reply to Re: -------------OPIATES FOR OCD???------------------- » DayByDay, posted by Ame Sans Vie on September 24, 2003, at 2:22:09
> > There are case reports and some research about opiates being effective in treating depression.
> > As far as OCD goes i´ve heard about Ultram and Morphine being effective.
> >
> > Is morphine a better choice than everyday Ultram consumtion since you only have to take it once a week to treat OCD and there probably not develop any significant tolerance/addiction?
>
> Either medication must be taken every day -- at first, the morphine may relieve you of your symptoms for a few days with a single dose, but tolerance develops to that very rapidly. That's why I'm sticking to Ultram (for now) and I'm about to try buprenorphine, since it's a mu-opioid agonist (like morphine, heroin, oxycodone), but also a kappa-opioid agonist. Thus, tolerance is limited with bupe. I just know that if I were to try morphine (or OxyContin, for that matter) as my doctors had suggested months ago, I'd be up to 800mg morphine/day by now... yikes.
>
> > Are there other opiates effective for treatment of OCD?
>
> Most seem to be effective, with the exceptions of the primary kappa-opioid agonists, such as pentazocine. Methadone, oxycodone, hydrocodone, codeine, dihydrocodeine, buprenorphine, Stadol, Talwin, Ultram, Demerol, LAAM, Duragesic -- these have all been shown quite helpful.
>
> > I know withdrawal symptoms and tolerance are individual. When it comes to tolerance some say the tolerance increase after a few weeks while I´ve heard about a friend using it for epilepsy (At least I think it was for epilepsy but don´t try using it against epilepsy because i say so,
> > i might be wrong, besides i think ít may have negative interaction with some anti-epileptic medicines) Anyway he is on the same dose for 4 years. Maybe it also depends on what you use it for.
>
> That certainly has quite a bit to do with it. When treating chronic pain, of course your dose will rapidly escalate; but if your problem is "simply" that you have an inadequacy within your endogenous opioid system (as so many OCDers seem to), then tolerance may not be an issue.
>
> > And I´ve heard about various other versions
> > as far as tolerance development goes
> > If you tried it for a longer time - when did > (if
> > it did) start to notice stronger tolerance(OCD and/or depression, would be interesting to hear as many experieces as possible.
>
> I haven't developed a bit of tolerance to Ultram over three and a half months, which is probably greatly helped by the fact that I take therapeutic doses of Robitussin regularly every day -- the NMDA antagonism that the active ingredient in Robitussin possesses can prevent tolerance or at the very least delay it.
>
> > Also if anyone have had any morphine treatment experieces for OCD and/or depression, i would appritiate if you could tell me how it worked?
>
> I've used morphine before, but found it far inferior to the Ultram. Ultram has a triple mechanism of action, which I think is *very* important.
>
> > It would be of very much help if someone could answer could answer at least one of my questions.
> > I have a quite problematic treatment-resistant OCD
> > which severly affects my life-quality-
> > I´m looking for diffrent alternatives to finaly and hopefully feel at least a moderate improvment of my life quality.
>
> I hope this answers some of your concerns. I'm always here if you have any more questions.
>Hey Ames, how are you, hey this is Ben, (temoigneur) here, the last thing in the world I want is for this to come across as smug or antagonistic, but I was just wondering why you are switching to buprenorphine if you haven't gained tolerance to Ultram and it's still working well. I only ask because getting my doctor to try Ultram will be a challenge, I wanted to go with what had the best chance of working right from the start. You seem very knowledgeable about the mechanisms of these drugs, does buprenorphine seem like a better candidate. What about the Ultram leaves room for improvement? Thanks again so much for taking the trouble to answer my q's.
take care, Ben
poster:temoigneur
thread:262687
URL: http://www.dr-bob.org/babble/20030923/msgs/263303.html