Posted by bleauberry on August 14, 2010, at 8:25:18
In reply to Re: Treatment Resistant Depression., posted by ed_uk2010 on August 13, 2010, at 22:35:06
Well, this is not really true. Yes, opioids do exert psychoactive effects. However, those effects differ. Some people become dysphoric. They don't need more endorphins help. Some people become euphoric...they also do not need endorphin help...they are just getting high from the excess. Other people however go from depressed to normal...pure normal...not high, not drugged, not euphoric, just plain normal...THAT is an easy diagnosis.
As far as the acceptance of something as a diagnostic tool, I personally could care less what academia accepts or not. They are so far removed from the real world they live in theory textbooks and statistics. More often than not, their conclusions of today are proven wrong 10 years from today. Many diagnostic tests of all kinds have errors, false negatives, false positives, and are prone to subjective interpretation or faulty interpretation. I don't trust em. They are not the gods many people see them as. They are not the authority and certainly not mine. If someone wants to wait for something to become "accepted" or "scientifically validated" (even there full of errors) they are going to probably remain ill for a very long time waiting. I guess overall what I am saying is that our depression and our health is in nobody's hands except our own. It is no one else's baby. A doctor can sure help and guide things, but it is not his baby. It's your life, my life, and we are responsible. For me to not take action in ruling in or ruling out something as simple as the endorphin hypothesis is irresponsible. IMO.
Vicodin is a diagnostic tool. It can rule in or rule out a suspect chemistry by observing the resulting behavior comparing pre-drug and during-drug. In the manner described above. Two doctors at my post op followup said they have seen papers recently of opioids treating depression, so they were not surprised at the idea. To them, it is already scientifically validated because it was in their medical journals, and to them is probably not quite accepted but at least in an open minded direction. No matter how much something is validated, there will always be a group of critics claiming the opposite. In the meantime, people stay sick.
If someone just doesn't want to mess with a full blown opioid, fine, they can still do some pretty good detective work with DPA, DLPA, LDN. Which years into TRD makes more sense than yet another antidepressant.
Ok, let's just take your position at face value and accept it. Ok, so someone has TRD, is given vicodin for surgery, experiences profound relief of depression and even some euphoria. Ok, opioids can do that. Doesn't mean anything. Except that...LDN or DLPA have a very high likelihood of coming close to the same result...a patient free of depression...because those substances work on the same chemistry as vicodin. That same patient staying instead with the ssris, antipsychotics, and mood stabilzers, is probably going to remain ill for a long time.
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> In order for something to gain acceptance as a diagnostic tool, its usefulness has to have been scientifically validated. Vicodin is not a diagnostic tool for anything except response to Vicodin :) Opioids frequently produce mood changes, elevation or otherwise, regardless of whether the person who took the drug is suffering from depression or not.
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poster:bleauberry
thread:958488
URL: http://www.dr-bob.org/babble/20100811/msgs/958554.html