![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 59 to 83 of 121. Go back in thread:
Posted by Elizabeth on November 28, 2001, at 16:06:52
In reply to Re: Morphine for depression. » Lorraine, posted by shelliR on November 28, 2001, at 0:02:48
> I don't know the difference between concerta and ritalin SR. Both are long-lasting ritalin.
They use different controlled-release technologies. Concerta is supposed to be better (i.e., lasts longer).
> Can your family always tell when you're depressed? Is there that big a difference in your behavior toawrd everyone?
You make it sound like you can usually "fake it." Can you? I can up to a point, but when the depression gets really bad, I can't really hide it (and often I don't even care about hiding it by the time it's that bad).
-elizabeth
Posted by Lorraine on November 28, 2001, at 18:47:52
In reply to Re: Morphine for depression. » Lorraine, posted by shelliR on November 28, 2001, at 0:02:48
Shelli:
> >
> Is this paragraph below about the retest the same day, or is this from your last test?My most recent QEEG (done last week).
> > My redone QEEG confirms pretty much his earlier assessment--that amphetamine and mood stabilizer are the ticket, but that Adderall is not doing the job. So he switched me to ritalin (I've tried dexidrine before). My initial reaction was increased anxiety, but I cut the dose down to 1/4 of a 10 mg tab 4x a day and that helps. I suspect we are going to try Ritalin SR next. He says the amplitude (or voltage) of alpha waves is low--to him this suggests amphetamines. We did a hyperventilating QEEG also, which showed that when I hyperventilate my voltage goes even lower (it should go higher), which he said indicates that under stress I have no power (voltage) to cope--which certainly is true. It is also true that I feel as though I am always trying to manage my power or energy level.
>
> I don't know the difference between concerta and ritalin SR. Both are long-lasting ritalin.They're the same--my mistake.
>
> >
> > Meanwhile, my alternative medicine doctor tested my amino acid levels and found low levels of several that are implicated with depression (methionine, phenylalinine, tryptophan, tyrosine, and glutamine) so a custom blend of amino acids reflecting my test results is being made. I will try these for 2 months to see if there is any improvement. I have tried a number of these individually, but she believes it is the combination that is important.
> >
> > >
> How does your pdoc feel about changing things from your alternative doctor; he doesn't worry that a change of enzymes might affect his tests and sort of muddy the field?I have to talk to him about it. It's hard to keep static though, you know. I'd like to get someplace stable for the holidays even if it is not permanent. The good thing is I don't have to wait weeks to find out if a stimulent is working.
> I did a long trial of Topomax, because at the time I was working with a pdoc who believed in long trials.Did you also lose weight on it like some people report? (That would be pretty odd to lose weight while sleeping.)
> >
> > I don't know, Shelli, you seem pretty patient to me:-)
>
> Well, sort of what choice do we have? Although I was quite ready to try opiates before anyone gave it to me because my depression was so painful, sometimes unbearable. It's always hard for me to explain why it is unbearable . And I don't even know what's exactly happening. Like where the hurt eminated from, except from my chest.
> > I can't believe I actually called them and asked them if I could kill myself. It was probably the stupidest thing I ever did because of course I knew what they would say and I also made them feel so bad.Maybe you needed to have them say it to you. On my birthday (just passed) I asked my husband and each of the kids to write me a note about why they loved me. It was great to read them, great (particularly for the kids) to think about why they loved me and I learned a lot about the entire family. But, part of the reason I had them write the notes was so that I could store them in my suicide file (where I keep letters that would stop me if I got to that point).
> That's why my pdocs threats are so scary to me; I can't control when I reach the end of the helpfulness of a dose.
This would really scare me also.
> >
> > I can really see the appeal to this, Shelli. Family expectations of performance go up when my mood stabilizes and then when my mood falls apart, don't adjust back down, which makes it hard.
>
> Can your family always tell when you're depressed? Is there that big a difference in your behavior toawrd everyone?Oh, yeah. They all know when I dip. I'm either weepy, lethargic or brittle. Plus I try to tell them so they won't think my behavior is because of something they did or didn't do. Sometimes I just ask to be left alone (when I want to sit and cry--I can comfort myself well enough with stacks of books and I don't want to be bringing everyone else down, though they feel the void anyway).
> > I want to go back on oxy I think, and I just never know when I'll reach the end of effectiveness. But thers's really no point in not living in the now. I can't control what happens with my body chemistry.
And you can bear the cost? If the methadone doesn't quite do it, can you combine the two (oxy and methadone)? or augment the methadone?
I hope things pick up again for you.
Lorraine
Posted by shelliR on November 28, 2001, at 19:36:13
In reply to Re: Morphine for depression. » shelliR, posted by Elizabeth on November 28, 2001, at 16:06:52
>
> > Can your family always tell when you're depressed? Is there that big a difference in your behavior toawrd everyone?
>
> You make it sound like you can usually "fake it."That seems like a strange thing to say to me.. I've never used the term fake it and I don't even think in those terms.
*Can you?
I can up to a point, but when the depression gets really bad, I can't really hide it (and often I don't even care about hiding it by the time it's that bad).
There are times that I am so severely depressed that I stay in bed all day, mostly sleeping. My cat loves it, I am like a big cat mom. But the stimulents make that a lot more difficult now (for better and worse). I find it amazing how I am able to come out of my depression (like when I am shooting, or even clients are over). I don't feel like I'm faking it; something happens, perhaps it's a good dissociation, where I don't feel anything about myself, including the depression. There were a few photo sessions before I went into the hospital in July, that that I could feel my depression (actually more of an irritation) for the first time, I thought that could never happen. That was shortly before I went on oxyconton.
Mostly I am able to come out of my depression enough to be civil, like if I had to run out to the store and see someone. But I live alone, so that makes things very different. When I asked the question to Lorraine, I meant do her children always notice the depression, or do they go right on chatting about themselves like teenagers generelly do.(Actually, I get the idea that her son is not a chatterer. And I waw also imaging that her husband knows but maybe you just go on many times as if you were not depressed.
>
What about your SO, Elizabeth? Do you consciously make an attempt to separate sometimes from the depression with him, not to fake your mood, but just to avoid, sort of let your relatiohship distract from the depression. Does he *want* to knew all your moods.Are you still doing well on your meds? And is your SO's depression still pretty much in remission since he started, was it remeron?
Shelli
Posted by SLS on November 29, 2001, at 17:51:19
In reply to Re: Morphine for depression. » Lorraine, posted by shelliR on November 28, 2001, at 0:02:48
> But I really didn't want to go. Then my pdoc increased my dose and things were okay again.
Hi Shelli.I'm not good for more than a few sentences, but a thought occurred to me as I read your post. Have you ever tried amantadine (Symmetrel)? It's a long shot, but if Lamictal helped a little, perhaps amantadine could help augment or reduce the induction of tolerance to opioids via NMDA receptor antagonism. Get one of the real brainiacs to look into it for you.
See 'ya.
- Scott
Posted by Elizabeth on November 30, 2001, at 1:17:51
In reply to Re: Morphine for depression. » Elizabeth, posted by shelliR on November 28, 2001, at 19:36:13
> > > Can your family always tell when you're depressed? Is there that big a difference in your behavior toawrd everyone?
> >
> > You make it sound like you can usually "fake it."
>
> That seems like a strange thing to say to me.. I've never used the term fake it and I don't even think in those terms.I just meant pretending not to be depressed.
> There are times that I am so severely depressed that I stay in bed all day, mostly sleeping.
Me too except for the sleeping part. (You know things are bad when you start thinking about abusing Zyprexa just so you can escape. :-} )
> But the stimulents make that a lot more difficult now (for better and worse).
Well...is it just more difficult to sleep, or is it also more difficult to lie around not caring about anything?
> I find it amazing how I am able to come out of my depression (like when I am shooting, or even clients are over). I don't feel like I'm faking it; something happens, perhaps it's a good dissociation, where I don't feel anything about myself, including the depression.
That sounds like more than what I mean by "faking it." It sounds like your depression is amenable to distraction -- a useful thing to know.
> What about your SO, Elizabeth? Do you consciously make an attempt to separate sometimes from the depression with him, not to fake your mood, but just to avoid, sort of let your relatiohship distract from the depression. Does he *want* to knew all your moods.
He's been depressed himself, and I don't feel I have to hide it from him, which is good because I'm a pretty crappy liar. < g > I'm not sure how trying to "separate" from the depression would be different from trying to feel better or pretend to feel better, but I've certainly attempted the latter two approaches without success.
Now, whether I *talk* to him about it or not is another story. Actually when I think about it, that depends more on him than on me, because I don't like to talk about it and that's not something I would do spontaneously. I don't try to hide it from him (like I said, bad liar), but when he's troubled about something, even if I'm depressed I will do my best to be supportive. I do make an active effort not to bring other people down, especially him.
> Are you still doing well on your meds? And is your SO's depression still pretty much in remission since he started, was it remeron?
He was taking CA Rocket Fuel+++ (he's the one who got me psyched about that), Remeron + Celexa + Provigil + Wellbutrin SR, but he was able to drop the Remeron (worried about weight gain, it was making him hungry) and is still doing well.
As for me -- comme ci, comme ca. My health insurance lapsed a couple months ago and I've been sort of in limbo trying to work something out in that regard.
-elizabeth
Posted by Elizabeth on November 30, 2001, at 1:18:38
In reply to Re: Morphine for depression. » shelliR, posted by SLS on November 29, 2001, at 17:51:19
> Have you ever tried amantadine (Symmetrel)? It's a long shot, but if Lamictal helped a little, perhaps amantadine could help augment or reduce the induction of tolerance to opioids via NMDA receptor antagonism.
I didn't know that about Lamictal or amantadine. I believe that the current thinking is that NMDA blockers don't really prevent tolerance, they just augment the opioid, alas. I've known a few people who used DXM to that end, although I'm not sure about the effective dose range.
-elizabeth
Posted by SLS on November 30, 2001, at 7:43:58
In reply to Re: Morphine for depression. » SLS, posted by Elizabeth on November 30, 2001, at 1:18:38
> > Have you ever tried amantadine (Symmetrel)? It's a long shot, but if Lamictal helped a little, perhaps amantadine could help augment or reduce the induction of tolerance to opioids via NMDA receptor antagonism.
>
> I didn't know that about Lamictal or amantadine.Lamotrigine inhibits the release of glutamate, thereby reducing NMDA stimulation. Amantadine (a relative of memantine) blocks NMDA receptors. It was probably a dumb idea.
> I believe that the current thinking is that NMDA blockers don't really prevent tolerance, they just augment the opioid, alas.
I see.
> I've known a few people who used DXM to that end,
For opioid enhancement or for the prevention of desensitization? Did it work?
- Scott
Posted by Elizabeth on November 30, 2001, at 14:50:18
In reply to Re: Morphine for depression. » Elizabeth, posted by SLS on November 30, 2001, at 7:43:58
> For opioid enhancement or for the prevention of desensitization? Did it work?
Sure it works, and like I said, they don't prevent tolerance; they just augment.
Thanks for the info about Lamictal and Symmetrel.
-e
Posted by shelliR on December 3, 2001, at 12:48:07
In reply to Re: Morphine for depression. » shelliR, posted by Lorraine on November 28, 2001, at 18:47:52
Lorraine,
> My most recent QEEG (done last week).
Are there changes in the QEEG since last time you had the test?
>I did a long trial of Topomax, because at the time I was working with a pdoc who believed in long trials.
> Did you also lose weight on it like some people report? (That would be pretty odd to lose weight while sleeping.)Right,no weight loss.
>
>
> weepy, lethargic or brittle. Plus I try to tell them so they won't think my behavior is because of something they did or didn't do. Sometimes I just ask to be left alone (when I want to sit and cry--I can comfort myself well enough with stacks of books and I don't want to be bringing everyone else down, though they feel the void anyway).That makes a lot of sense. Sort of like you were feeling sick in any other way. How is your son doing, and your daughter with her "new" sense of herself in the family after seeing his therapist?
And your next trial is to change the stimulent or try another mood stablizer, I can't remember. what's going on with your meds?Shelli
Posted by Lorraine on December 4, 2001, at 10:01:21
In reply to Re: Morphine for depression. » Lorraine, posted by shelliR on December 3, 2001, at 12:48:07
Shelli:
I'm on a trial of concerta and neurontin. I was on ridalin and neurontin--but that was too much up and down. I've only been on the concerta a short time (2 days) so too early to tell. I've been a bit down but then I am withdrawing from a shorter term amphetamine (ritalin) so my body may be adjusting. Anyway I haven't been posting much b/c it just seems like this is "process" work, try one drug and then another and then another. I don't see magic bullets, just one foot in front of the other until things work.
Lorraine
Posted by shelliR on December 4, 2001, at 21:30:34
In reply to Re: Morphine for depression. » shelliR, posted by Lorraine on December 4, 2001, at 10:01:21
> Shelli:
>
> I'm on a trial of concerta and neurontin. I was on ridalin and neurontin--but that was too much up and down. I've only been on the concerta a short time (2 days) so too early to tell. I've been a bit down but then I am withdrawing from a shorter term amphetamine (ritalin) so my body may be adjusting. Anyway I haven't been posting much b/c it just seems like this is "process" work, try one drug and then another and then another. I don't see magic bullets, just one foot in front of the other until things work.
>
> LorraineHi Lorraine,
Well, I like to know where you're walking, so let me/us know, okay? Is the plan to find the right stimulent with the right mood stabilizer, and leave ADs out of the picture? I am on cercerta. I couldn't adjust to any of the stimulents until I was on with a narcotic. And now I really don't know whether it makes a difference whether or not I take it, even though I'm up to 54mg a day.
Actually, you could probably take away most of my other drugs and it wouldn't make a difference. I am also up to 400 mg of wellbutrin, but I'm still very very tired late afternoon. I have this theory that life is just too much to last a full day, and if I take a 30minute nap, everything feels better. I'm going to try spliting the concerta to twice a day, try to get around that theory. The only reason I care is when I am not home, or when people want to pick up stuff in the late afternoon, I can't take a nap, and then I almost fall asleep sitting up at about 8pm. (and wake up at 9 or 10, because my body thinks it's a nap, not time to sleep)Take care,
Shelli
Posted by manowar on December 5, 2001, at 13:05:26
In reply to Re: Methadone for depression. » Lorraine, posted by shelliR on December 4, 2001, at 21:30:34
> I'm going to try spliting the concerta to twice a day, try to get around that theory.
Hi Shelly,
From what my pdoc told me, Concerta is just Ritalin XR that works a lot better than the drug Ritalin XR. He told me that 1/3 of it is released immediately, 1/3 is released 3 hours later and the last 1/3 is released 3 hours later. I found that it works great and it is effective for me for 8-10 hours.Since the Concerta is a timed-release preparation, I don't think it would be a good idea to split it in half. You may need a higher dose for it to be effective.
This is what I'm doing:
Since the Concerta (72 mg) wears off for me around 4-6 in the afternoon, my pdoc gave me a script for regular Ritalin (20 mg) so that I could take one when the Concerta starts to wear off. The Ritalin last for 3-4 hours.
--Tim
Posted by shelliR on December 5, 2001, at 13:59:03
In reply to Re: Methadone for depression. » shelliR, posted by manowar on December 5, 2001, at 13:05:26
Hi Tim,
> From what my pdoc told me, Concerta is just Ritalin XR that works a lot better than the drug Ritalin XR. He told me that 1/3 of it is released immediately, 1/3 is released 3 hours later and the last 1/3 is released 3 hours later. I found that it works great and it is effective for me for 8-10 hours.
>Is Ritalin XR still available? If it is, it might be related to a paten release. Or a way to get around a name that seems to be so associated with ADD?
> Since the Concerta is a timed-release preparation, I don't think it would be a good idea to split it in half. You may need a higher dose for it to be effective.Sorry, you're right. I did come across as if I meant splitting the pill. I actually meant splitting the dose-2 morning, 1 early afternoon.
>
> This is what I'm doing:
> Since the Concerta (72 mg) wears off for me around 4-6 in the afternoon, my pdoc gave me a script for regular Ritalin (20 mg) so that I could take one when the Concerta starts to wear off. The Ritalin last for 3-4 hours.I think that's a good plan. I didn't want to have to keep track of one more pill (to get a prescription of, renewal, etc, of ritalin.) It's already scary (to me) how many different drugs I'm taking for depression.
Shelli
Posted by JahL on December 6, 2001, at 11:34:15
In reply to Re: Morphine for depression. » Lorraine, posted by shelliR on November 28, 2001, at 0:02:48
> > > Anyway, I am excited that the methodone seems positive (although not perfect) and I find myself looking forward to things that may be around the corner. It would be interesting after all of this searching we both ended up with methodone as the pain mood stabilizer after all these other trials.
> Now I am less excited. I want to go back on oxy I think, and I just never know when I'll reach the end of effectiveness. But thers's really no point in not living in the now. I can't control what happens with my body chemistry.Hi Shelli.
Don't presently have the motivation to trawl thru long threads. Was wondering why you wanted to return 2 Oxy. Methadone not doing the trick? Can you tell me why you prefer the 'real' opiates (or is that a silly Q??)? What dose are you taking?
That specialist guy I was telling you about as good as told me to try anything I can get my hands on. He told me they're currently 'burying bodies' which might otherwise be saved were it not for restrictive, draconian govt. legislation concerning opioids and the like. It would seem his hands are tied...
I think Methadone low-dose is helping a little. Now I've got the green (in both senses of the word) light.......
Hope you're doing OK,
J.
Posted by jazzdog on December 6, 2001, at 12:20:58
In reply to Re: Methadone for depression. » shelliR, posted by JahL on December 6, 2001, at 11:34:15
Hi Jahl-
So what did your pharmacologist have to say about depersonalization? And new ideas?
- Jane
Posted by JahL on December 6, 2001, at 18:44:03
In reply to Re: pharmacologist report? » JahL, posted by jazzdog on December 6, 2001, at 12:20:58
> Hi Jahl-
>
> So what did your pharmacologist have to say about depersonalization? And new ideas?Hi Jane.
You know what, I did the full 90 minutes w/o mentioning depersonalisation. Might have something to do with having only 3 hours sleep over 2 days & a sodding 6 hr round trip.Also I'm not especially depersonalised at present and because I've been this way all my life, I only tend to notice when the DP is particularly bad. Actually, I found it pretty easy to connect today & I know I gave a good a/c of myself. I suspect it may have had something to do with the low-dose Methadone I'm taking, though I wouldn't like to comment further until I've upped the dose. I've actually spied a couple of articles implicating the endogenous opioid system in DD disorders. I think there are at least 2 board members here who suffer from dissociative disorder and benefit from opioids...
We concentrated on BPII as a single entity and mainly focussed on the depression. When this remits, so do all my other symptoms.
He said that as far as British psychiatry was concerned I had already pushed the envelope far beyond what was considered 'reasonable' and that I would probably have a better chance treating myself, "given you seem to know more than the average psychiatrist." < g > (I know sh*t-all)
His main suggestion was to retain all present meds and add Tryptophan to augment the SSRI (currently Celexa). Of course this is not popular practice in the US right now because of the past EMS scares but he assures me he has had some success with this method (tho he doesn't deny that there still exists a theoretical risk).
I have a modicum of faith if only because this was the first pdoc I've ever met who truly knows his stuff. No pretence. No picking apart of my childhood. No condemnation for my drug *use*. You get the picture. Easily the most valuable 90 mins I've ever spent with a doc ('cept the one who operated on my hand...) It's just a shame I finally find this person when my journey seems to be nearing its end...
Rgds,
J.PS I'm still technically at the DP unit so I'll keep you abreast of any developments. However they've recently started mumbling about 'disability management' & the like which doesn't sound too promising...
Posted by Lorraine on December 6, 2001, at 20:20:43
In reply to Re: Methadone for depression. » Lorraine, posted by shelliR on December 4, 2001, at 21:30:34
Shelli:
I'll keep you posted. I think the plan is to try the stimulants first. Concerta is supposed to last 12 hours I think--which is a short day so staggering your doses might make sense. I'm on the lowest dosage 16 mg so that's not an option. I'm still not sure where I am with it anyway. Pretty sure the transition from short action to sustained release is done, but then there's figuring out the Neurontin piece, which has come down (from 1500mg a day to about 800-900 mg a day) and my system is probably still adjusting to that decrease. Anyway, cutting a long ramble short, I'll keep you posted. Thanks for the concern.
Lorraine
> Well, I like to know where you're walking, so let me/us know, okay? Is the plan to find the right stimulent with the right mood stabilizer, and leave ADs out of the picture? I am on cercerta. I couldn't adjust to any of the stimulents until I was on with a narcotic. And now I really don't know whether it makes a difference whether or not I take it, even though I'm up to 54mg a day.
> Actually, you could probably take away most of my other drugs and it wouldn't make a difference. I am also up to 400 mg of wellbutrin, but I'm still very very tired late afternoon. I have this theory that life is just too much to last a full day, and if I take a 30minute nap, everything feels better. I'm going to try spliting the concerta to twice a day, try to get around that theory. The only reason I care is when I am not home, or when people want to pick up stuff in the late afternoon, I can't take a nap, and then I almost fall asleep sitting up at about 8pm. (and wake up at 9 or 10, because my body thinks it's a nap, not time to sleep)
>
> Take care,
> Shelli
Posted by jscottb on December 6, 2001, at 21:19:59
In reply to Re: Morphine for depression. » Lorraine, posted by shelliR on November 16, 2001, at 12:30:36
> Wow. I'm really curious about the use of an opiate for depression. I suffer from depression and I still battle my demons with opiates. Although I have been opiate free for almost 4 months, I still fight the battle every day. I got in trouble for prescription fraud, and I must never entertain those thoughts again. I take Paxil for depression, but opiates have always done wonders for that. I admit it. I love opiates. How could I proceed in finding the right doctor? Thanks.
> >
> > Shelli: It's Lorraine jumping in. I just wanted to see how you are doing on the Oxy. Have you stablized? Is your depression under control? I had an allergic reaction to Nardil (inflamed swollen hands, lose of feeling in fingertips--actually listed as a known side effect) and had to go off. I'm deciding my next step and opiates are on the agenda but probably not my next step.
> >
> > Lorraine
>
>
> Hi Lorraine,
>
> Good to hear from you, wish it were under better circumstances. When did the nardil reaction occur?
>
> It's been about five or six weeks since I've been on this dose of oxy and my depression is under control. I don't think that's long enough to tell although I am very hopeful. I just went up another 20mg, but only because I have thought the last time I went up that it was slightly lower than it could be--I mean I'm already habituated, why not feel as good as possible, without feeling at all drugged.
>
> Unfortunately, it looks like I *will* be switching to methodone in a few weeks because they haven't even received the paperwork in my pdoc's office. I am only allowed to get it from them and they are putting zero energy into it. It is horrible timing for a med change in terms of work, but hopefully the transition will not be a huge deal.
>
> If I become unstabilized on either oxy or methodone, it will be a hugh jolt. I am willing to go as high as my pdoc will let me, if it means not being depressed. I am still unstable premenstrually, but that's more fear, and anxiety, specifically around finishing all commitments with work and around the fear that my doctor can stop working with me any time he chooses and I would have to detox. And then I would be at square one with the depression. I also have no guarantee that methodone will have the same effect as oxy, but he
> seems to think so. Monday, I'll ask him why methodone rather than morphine, but I won't hold my breath expecting an answer.
>
> If I feel like this during the next year, that is good enough. My feelings are more good than bad, and the bad involves insecurity rather than depression.
>
> How bad is your depression now? What do you see as possibilities for your next trial. Also, have you
> discussed opiates with your doctor, or are you
> assuming from knowing him,that he will be supportive around this?
>
> BTW, opiates make me anorgasmic, but I figure if I'm ever "involved" I can skip the evening dose. I have never heard Elizabeth say that she has had any sexual problems with buprenorphine.
>
> Good luck on your next decision. Keep us informed.
>
> Shelli
Posted by jazzdog on December 7, 2001, at 12:22:20
In reply to Re: pharmacologist report? » jazzdog, posted by JahL on December 6, 2001, at 18:44:03
Thanks for the update. Good to know somebody is out there who makes some sense to you. Good luck with the tryptophan and methadone.
- Jane
Posted by judy1 on December 8, 2001, at 4:03:01
In reply to Re: Morphine for depression. (how to find doc?), posted by jscottb on December 6, 2001, at 21:19:59
If you are truly treatment resistant, you might try a mood disorder program at a University- many of them use opiates with their patients who don't respond to every other AD and combo. I suspect that people on this board have tried EVERYTHING with their docs and it was kind of a last resort. If you fall in that category, it's worth a shot in asking. As far as the prescription fraud goes, I see that as an effort to self- medicate, but a lot of docs won't. Take care, judy
Posted by Elizabeth on December 8, 2001, at 7:32:24
In reply to Re: Morphine for depression. (how to find doc?) » jscottb, posted by judy1 on December 8, 2001, at 4:03:01
> If you are truly treatment resistant, you might try a mood disorder program at a University- many of them use opiates with their patients who don't respond to every other AD and combo.
I wouldn't say "many." It's unfortunate, but there are a lot of doctors out there who have the rigid, inflexible attitude that opioids are not "appropriate" for treatment of depression. I know there are many of us who only respond to opioids, but I'm afraid we aren't going to see opioid antidepressant treatment become standard in our lifetimes.
> I suspect that people on this board have tried EVERYTHING with their docs and it was kind of a last resort. If you fall in that category, it's worth a shot in asking.
And do your best to make it clear to the doctor that you're not just looking to get high or whatever. Seriously: it seems like doctors almost automatically mistrust anyone who asks for opioids.
-elizabeth
Posted by shelliR on December 8, 2001, at 14:31:27
In reply to Re: Methadone for depression. » shelliR, posted by JahL on December 6, 2001, at 11:34:15
>
> Hi Shelli.
>
Hi Jah,
> I think Methadone low-dose is helping a little. Now I've got the green (in both senses of the word) light.......do you have enough of a source for you to be secure in knowing that if it works, it will be there for you?
And will you see this guy again to see how the new med combo works? Is he still your doctor?
What does this mean: PS I'm still technically at the DP unit so I'll keep you abreast of any developments.
Are you physically in the hospital, or does unit mean your file is still being kept in the huge bureaucratic UK system at a certain specialty and they may continue to treat you?
You can perhaps answer those questions in one answer, because they might all be related, except the supply question.
Its hard to translate the UK system from over here.
I don't know if there is much of a difference in how I feel between methadone and oxycontin. It's more that my doctor is telling me that it "should"
last for at least 12 hours and it's lasting for only 8 hours. And it was a bad time to switch because it's the busy season until christmas with my business. So with the oxy, he was allowing me to take an extra dose at night and now he is fighting that.It's all so crazy with this pdoc. I mean who's taking the med, him or me. It doesn't make me high at all, so way would I say it's wearing off too soon if it wasn't. It just means that I have more
rebound depression in the morning. I already went through that and settled it with oxycontin and now he is again saying your at the highest level, etc. etc. And I say what is the plan, and he has none.
I think it would have been better to start with methadone because the increases in doses would have been so much smaller and I could have started so low. I am taking 110mg, but the oxy had gotten me really high up in mg.Anyway, I am a wreak, I need a new pdoc, but yes, the methadone, even with this guy, is better than no opiates without this guy.
Keep us informed. After Christmas I hope to turn into a person again.
Shelli
Posted by shelliR on December 8, 2001, at 14:49:33
In reply to Re: Morphine for depression. (how to find doc?) » jscottb, posted by judy1 on December 8, 2001, at 4:03:01
> If you are truly treatment resistant, you might try a mood disorder program at a University- many of them use opiates with their patients who don't respond to every other AD and combo. I suspect that people on this board have tried EVERYTHING with their docs and it was kind of a last resort. If you fall in that category, it's worth a shot in asking. As far as the prescription fraud goes, I see that as an effort to self- medicate, but a lot of docs won't. Take care, judy
Hi Judy.
It's always so good to see your name on the board, when you've been or I've been away for a little while. How is your detox going? When you have the baby, please check in and tell us (please?)
After the Christmas rush, I need to find a new pdoc. I would like to restart with opiates, and also find a better combination with my other meds. And I would like to get as far away as I can from my present pdoc who makes me feel sicker.
I don't know what you mean about universities using opiates as a last resort in their mood disorders program. Is this just a California thing--maybe moving over to the east coast in a few years? Any specifics on Universities?
If you feel comfortable to do this (and you have time) could you e-mail me at stacey1012km@yahoo.com so I could ask you for any leads you might have. If not, I have other people helping me with this also, so it's okay. I am just going to have to look and look. It's good that I'm already on methadone I think, and I'm not getting off until I find another pdoc to help me with my meds, even if it means going to another state. I would rather, find someone in my location first (washington, d.c. or baltimore md, or at least on the east coast. California might be my last option, but it is an option). I'm talking about the quality of my life, as you and everyone on this board understands.
Take care,
Shelli
Posted by Elizabeth on December 8, 2001, at 20:03:28
In reply to Re: Methadone for depression. » JahL, posted by shelliR on December 8, 2001, at 14:31:27
> I don't know if there is much of a difference in how I feel between methadone and oxycontin. It's more that my doctor is telling me that it "should"
> last for at least 12 hours and it's lasting for only 8 hours.Methadone is given once daily to addicts on maintenance therapy, but for pain it's supposed to be given several times a day. I think that we're more like pain patients in that respect. (When bupe is used for maintenance treatment of opioid dependence, it's given once daily as well, but I need to take it every 4-6 hrs.)
-elizabeth
Posted by Elizabeth on December 8, 2001, at 20:05:13
In reply to Re:methadone for depression. (how to find doc?) » judy1, posted by shelliR on December 8, 2001, at 14:49:33
> I don't know what you mean about universities using opiates as a last resort in their mood disorders program. Is this just a California thing--maybe moving over to the east coast in a few years? Any specifics on Universities?
I had mostly heard of it being done at Harvard, actually (that's how I originally got prescribed bupe, when I was living in Cambridge).
-e
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