Posted by hello123 on January 29, 2015, at 17:47:03
In reply to Re: feeling like im out of options » hello123, posted by europerep on January 29, 2015, at 16:39:00
> Hmm, there is a bit of confusion in the thread now. Ed has already pointed out everything about the different mechanisms of action, so I'll just reply directly to what you said.
>
> I don't think it is rational to try naltrexone as a substitute for buprenorphine, for various reasons. Primarily, it lacks the properties of buprenorphine and norbuprenorphine on mu- and delta-receptors, which I would personally suspect to play at least some role in the antidepressant effects of buprenorphine. And naltrexone is actually fairly extensive used for various illnesses (compared to buprenorphine in treatment-resistant depression), so if naltrexone had antidepressant properties, we would have some solid knowledge about it. Not necessarily from the Journal of Clinical Psychiatry, but certainly from patients. I just have difficulty understanding why you seem to have some faith in science and pharmacological treatments, but you stubbornly refuse to try tranylcypromine or phenelzine. Some people call them the gold standard for treatment-resistant depression.
>
> As for what I said about clinicians, I of course meant clinicians who can back their statements up with science, as those who recommend MAOIs for treatment-resistant depression can.
>
> I don't want this here to become some kind of proving-each-other-wrong thing, because that is not my intention. I would personally like it if you reflected a bit about where you're most likely to find a working treatment, and then go in that direction. But you're obviously free to decide, so I'll leave it at that.
>I was simply hoping to benefit from from Naltrexones Kappa antagonism, since it has been shown to benefit Depression. The medication in Clinical Trials that i posted on works to treat Depressin with its blockade of the Kappa receptors. The FDA thinks this med has so much potential to benefit people that it has fast-tracked its approval:
http://mentalhealthdaily.com/2014/08/05/new-antidepressant-alks-5461-trials-2016-expected-availability/some info of Kappa antagonism from this article: "So why block the kappa receptor? When the kappa-opioid receptor becomes activated, naturally occurring peptides called dynorphins are released. Some research suggests that dynorphin levels are elevated among people with depression. Therefore blocking the kappa receptor will result in dynorphin reductions and may yield an antidepressant-like response.
Although dynorphins are important in a persons stress response, at high levels they block the release of glutamate. Blocking glutamate in the brain can prevent neuroplasticity, lead to poorer learning abilities, and can induce learned helplessness. Since ALKS-5461 would be blocking dynorphin, it is thought that glutamate would get released to increase hippocampal plasticity and thereby reversing learned helplessness.
Additionally, blocking dynorphin can improve signaling of dopamine, which could lead to further reductions in depressive symptoms as a result of stress. Many researchers believe that kappa-opioid receptor antagonists may be a valid treatment option for both depression and anxiety in the future. In animal studies with kappa-opioid receptor antagonists, significant improvements in depression, anxiety, anhedonia, drug addiction, and stress-related behaviors has been shown."
and i dont know why youd say i seem stubborn about trying either of those MAOI's after i posted this in one of my posts above:
"thats good to hear the effects from MAOI's feel much different than Reuptake Inhibitors for you. Thanks and it makes me feel more hopeful about trying them."though i am nervous about trying something with strong MAO-A inhibition because of the food restrictions.
also, as i said, i have Depersonalization, and Naltrexone has been shown to benefit this. http://www.ncbi.nlm.nih.gov/pubmed/15876908
and if you Google "naltrexone Depersonalization", you will see much talk about it on Forums about it being used to treat Depersonalization.
poster:hello123
thread:1075467
URL: http://www.dr-bob.org/babble/20150129/msgs/1075734.html