![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 63 to 87 of 262. Go back in thread:
Posted by bee happy on January 27, 2003, at 15:19:02
In reply to Buprenorphine-- bee happy, posted by Peter S. on January 26, 2003, at 22:24:18
To elaborate on my battle with depression would only make you more depressed. The darkness fell about two years ago. After seeing a therapist for several weeks she came to the conclusion that it must be chemical,and referred me to a "pdoc" for the grueling months of trying all the new improved meds.The ones I can remember are Serzone, Wellbutrin, Prozac, Celexa, all of them made me feel worse..some of them made me physically ill.i had an alergic reaction to Serzone and was a walking mucus membrane for a week. I think I tried about 10 different things within the year. In speaking with my therapist I mentioned(in the very first visit) that I had always felt normal on codiene. That I had in fact had a problem with it in my youth and went through rehab to stop.(17 years ago). One day in session her face lit up and said she had heard of a study using opiates for depression and I should ask the pdoc about it. He had heard of it but wanted to get more information before sending me off with a prescription.Psychiatrists are busy treating some very sick psycotic patients with problems far worse than mine and I knew it would be up to me to find the research.I was very motivated. Here was someone telling me that perhaps I was not a druggie but had been self medicating depression all those years.I found the research study on the internet..right down to individual histories and results. Armed with that...he first tied Tramadol and then Buprenorphine. Tramadol seemed only to relieve the physical achiness that I felt not the anhedonia and fantasies of driving my car off a cliff on the Big Sur Hwy. It did nothing to change my mental state. You asked about dosage and weather I have built up a tolerance. I started on very small dosage .3mg 3 x's a day. and escalated to 2 mg 4 X's a day over the course of three months. It would apprear that I had built up a tolerance if I had not read that in treating with Methadone or Buprenorphine dosage is everything and too little can be as bad as too much. I have leveled off to 2 mg 3x's a day and sometimes I actually forget to take it.So that must say something, I'm not sure what. I have read that buprnorphine maintenance patients can go 2 days without their dose. So, am I just an ex opiate addict on Buprenorphine maintenance or a depression patient on the one drug that works for me? My family doctor likens it to a Diabetic...who without insulin would die. If I were not on this drug I'm not sure I'd be here writing this. It was that bad. I am on a compunded sub lingual gummy lozenge now. But Subutex and Suboxone have already been approved for addiction treatment in the U.S.and your family doctor can prescribe a drug for something other than it was approved. I think you will be hearing alot more about this in the very near future. I hope there is a backlash on this fear of prescribing. Yes there are doctors who might abuse the privilege...monitoring their writing practices is a good thing, but don't make good doctors afraid of using good medicine when necessary. I am lucky to have 2 doctors,who knowing my history, were not afraid. God bless them. Sorry to have gotten off on a moral rant...but "Blah's" story really hit me as the Catch 22 of "modern medicine". He's the reason I posted in the first place. I had been a lurker here for some time and was just checking in to see how some of the folks were doing. I am not Rececca of Sunnybrook Farm. I really do like bees. Alot. You asked about side effects. An odd one considering that opiates are known to constipate. I am a clockwork wonder now. That's all for me. No others. I wish I were better at explaining how it effects me....it's not a high...it's more a feeing of well being. I still get anxious at times and sad or angry when appropriate...it's does not numb me. It makes me feel the way I thought normal people felt all those years when I knew I was not "normal". More in the moment. Be here now. Now, I am. I hope this helps someone. It felt good to tell it. Thanks all.
Posted by juanantoniod on January 27, 2003, at 16:26:33
In reply to Re: opiates and major depression, posted by androog on January 27, 2003, at 1:49:04
I just did a search for Buprenorphine and deprssion in Medline and came up with 0 matches. Anyone else have better luck locating the studies supporting opiate use for depression?
Antonio
Posted by juanantoniod on January 27, 2003, at 18:38:27
In reply to Re: opiates and major depression, posted by juanantoniod on January 27, 2003, at 16:26:33
Forgive my ignorance. I just went to the Journal of Clinical Psychiatry's Website for this information and found the article. You may find them at psychiatrist.com.
> I just did a search for Buprenorphine and deprssion in Medline and came up with 0 matches. Anyone else have better luck locating the studies supporting opiate use for depression?
>
> Antonio
Posted by BrittPark on January 27, 2003, at 18:51:47
In reply to Re: opiates and major depression, posted by juanantoniod on January 27, 2003, at 16:26:33
I just did a medline on "buprenorphine depression" and got 161 hits. Almost all are concerned with respiratory depression. There are three relevant references:
Biol Psychiatry 1996 Jun 15;39(12):989-90
Buprenorphine for depression: the un-adoptable orphan.Callaway E.
Publication Types:
EditorialJ Clin Psychopharmacol 1995 Feb;15(1):49-57
Buprenorphine treatment of refractory depression.Bodkin JA, Zornberg GL, Lukas SE, Cole JO.
McLean Hospital, Consolidated Department of Psychiatry, Harvard Medical School, Belmont, MA 02178, USA.
Opiates were used to treat major depression until the mid-1950s. The advent of opioids with mixed agonist-antagonist or partial agonist activity, with reduced dependence and abuse liabilities, has made possible the reevaluation of opioids for this indication. This is of potential importance for the population of depressed patients who are unresponsive to or intolerant of conventional antidepressant agents. Ten subjects with treatment-refractory, unipolar, nonpsychotic, major depression were treated with the opioid partial agonist buprenorphine in an open-label study. Three subjects were unable to tolerate more than two doses because of side effects including malaise, nausea, and dysphoria. The remaining seven completed 4 to 6 weeks of treatment and as a group showed clinically striking improvement in both subjective and objective measures of depression. Much of this improvement was observed by the end of 1 week of treatment and persisted throughout the trial. Four subjects achieved complete remission of symptoms by the end of the trial (Hamilton Rating Scale for Depression scores < or = 6), two were moderately improved, and one deteriorated. These findings suggest a possible role for buprenorphine in treating refractory depression.
Lancet 1982 Sep 25;2(8300):709
Antidepressant effects of buprenorphine.
Emrich HM, Vogt P, Herz A, Kissling W.
Publication Types:
Clinical Trial
Letter
Randomized Controlled TrialAs you can see there hasn't been much research into opioids as antidepressants. My guess is that the DEA discourages the NIH from funding such studies. Sad but true for the forseeable future.
Cheers,
Britt
Posted by BrittPark on January 27, 2003, at 19:57:25
In reply to Re: opiates and major depression, posted by juanantoniod on January 27, 2003, at 18:38:27
I found a pdf of a Dr. Callaway's editorial. It pretty much sums up the sad state of opioid therapy.
It can be found at http://www.sciencething.org/Callaway.pdf
Posted by Mattkit on January 27, 2003, at 23:09:58
In reply to Re: Buprenorphine-- bee happy, posted by bee happy on January 27, 2003, at 15:19:02
Wow Bee thanks this sounded alot like my experience and gives me hope that I may also
do well on this
geez its amazing how a message board can help
your life
thanks again
Posted by bee happy on January 27, 2003, at 23:18:12
In reply to Re: opiates and major depression, posted by BrittPark on January 27, 2003, at 19:57:25
http://balder.prohosting.com/~adhpage/bupe.html The above is the internet location for the research study on Buprenorphine and depression. No spelling is not a side effect. I couldn't spell before. Or type !
Posted by Blah on January 27, 2003, at 23:18:12
In reply to Re: opiates and major depression » juanantoniod, posted by BrittPark on January 27, 2003, at 18:51:47
I know a pdoc who would rx buprenorphine, but she says it's not in stores yet, and I think she's waiting for something from the gov. too, but maybe she's just waiting for it to come to drug stores. I think I may switch to her anyway though. I'm not sure about this specialist. He expects me to try a plethera of other medications before I try an opioid, and I do not have that kind of time or energy anymore. I'm also running out of ambien, and if at my next visit he is not willing to give me an rx I will dump him. Often I find it impossible to sleep. This has been true my whole life. My body is not capable of a sleep schedule, I've tryed many times. When I can't sleep I must have ambien cause this is maybe the most depressing and dangerous time for me. If this "specialist" can't understand that , and instead drones on about addiction (which believe me is not a problem for me I only take it when I need it) then I will dump him and go to the other one. More reasources means nothing if you don't care about the suffering of your patient. However there is another problem. I know that I have many personality dissorder traits along with the depression. I have come to the conclusion that my core problem may be traits of schizotypal personality disorder, which means I'm mildly psycotic, even autistic in some ways. I don't have hallucinations or unearthly delusions, but I feel so separated from people even though I can empathise with them. When I try to do things alone I get lost in myself, this is of course much worse the more depressed I am. When I have occasionaly felt good or even when I had hope I still had difficulty, but I could still push through, and even have some succssess. However, I don't feel good at all anymore, and I have no hope left. I feel angry that after all my years in the mental health system I had to figure this out for myself. I've been told everything from 'I wasn't doing my school work or cleaning my room so I could get back at my parents' to 'I was lazy' to 'I was just trying to get attention by being different' to 'its because you have no selfesteem' I now see that all my deniles of these premesses were right, my lack of self esteem came from a knowledge of my limits contrasted with what others expected of me, and made me expect of myself. I was a fool to listen to anyone above myself, even if they did have a Phd. after their names. Supposedly the only drugs that would help my thought problems are antipsycotics. I refuse to take these drugs. They all have the possibility of PERMANANT parkinsons like symtoms (loss of motor control) I have nothing already, to loose even more control of my body would finish me. The only one that doesn't have this possibility is Clozapine, but you must get weekly drug screenings cause it will kill all your white blood cells. My Imunesystem is week enough already thank you. Antidepressants are sometimes given for the accompanying depression, but we already know they don't work for me. I'm willing to try maybe two mood stabalizers, but that's it. I will not try endless drugs from the same class ever again. I'm also thinking of experimenting with smart drugs from europe which aren't available here, but are not controled substances. The best thing for me would be a loving and supportive attmospher, but that won't exist for me while I'm in so much mental and physical pain. Maybe in this increasingly fascist world that support is never possible for me, but if an Opioid lets me feel some joy, and lets me function to some extent maybe I can find a satisfying way to be a part of it... Somehow.
Posted by Blah on January 27, 2003, at 23:42:48
In reply to Re: opiates and major depression, posted by bee happy on January 27, 2003, at 23:18:12
I showed my last pdoc that study she hardly read it an laughed in my face. She made very mocking remarks about my continuos irritable bowel symtoms, "This will probably give you diarea, ha ha." This is psyciatry not science: facts mean nothing! In the 50s homosexuality was considered psychopatic and they were given ECT and Labotomies. In the 80s and 90s people were druged and hypnotized till they showed multipe personalities, and addmitted to being ritualy abused by satanists. Today the drug companies rule even though more and more people aren't getting better, and pdocs tout genetics as the key even though not a single genetic study has been able to be repeated (like Dean Hammers infamous gay gene study). In the end consensus is not proof. Pdocs are by far the most arogant of all dr.s with very few exception. Anything out of there accepted bag of tricks usually meets with "Oh you silly silly patient", a fear of loosing control over you, or worse being chastized because you have blastfeemed against their holy faith.
I'm sorry if this sounds synical, but I used to trust pdocs. When their drugs didn't work they would blame me, and I would feel terrible guilt even though I knew I did nothing wrong. Now I take an active part of my own treatment, and they are very threatened by this, and that fear always replaces compasion, because they don't care bout me much to begin with. Except for a select few, I feel pdocs are the most defencive, insencitive, egotistical monsters on the face of the planet.
Sorry, that's just how I've come to feel.
Posted by Blah on January 28, 2003, at 0:03:26
In reply to Re: opiates and major depression » bee happy, posted by Blah on January 27, 2003, at 23:42:48
I'm sorry again if my last post was too angry. I'm in a bad place right now. I've been in both terrible mental and physical pain for the last week. The Specialist detatchment from my needs has filled me with stress, it's the same old story. There is no recovery in sight., or even a temporary release. Nothing distracts me anymore. Nothing is enjoyable anymore, and it's now that I realize my own mild psycosis. I'm so alone, and I've been alone for so long. I've been treated badly and judged by so many, especially people in power. To go to a doctor who is suppost to help you and face the same behavior when you've been hurting for so long, and are reaching your limit... I don't know what else to say. I just don't know what else I can say.
I'm Sorry
Posted by Stan on January 28, 2003, at 3:27:49
In reply to Opioids and anxiety...?, posted by Ame Sans Vie on January 27, 2003, at 4:14:08
> Well, in the past I've been prescribed Hycodan (Canadian formulation), propoxyphene HCl, codeine, and hydromorphone. The Hycodan (at a dose of 15mg q8hr) worked especially well-- it both relieved the anxiety, yet didn't have me throwing up all day. I'm interested in trying buprenorphine, and it shouldn't be difficult to obtain it (or hydrocodone) seeing as my pdoc already has me on Klonopin, Valium, Ativan, Xanax, and just a few days ago called in prescriptions for BuSpar and Marinol (which works incredibly well, I might add... I'd rather not be taking it though, on the basis of drug testing for when I finally get out to look for a job. I have the feeling that most employers would frown upon finding THC in your system, even if it were backed up by a Rx). Another consideration is Stadol (butorphanol) nasal spray-- anyone have any experience at all with this stuff? I've used it recreationally years ago, but that was before my disorder(s?) hit full force. TIA!
>
> --Michaelhi michael - does your pdoc have you taking all four of those different benzos on a daily basis? if so, what's the rationale behind that approach? (if you don't mind my asking)
have you tried settling on just one? it might simplify matters......just curious
Stan
Posted by androog on January 28, 2003, at 11:15:15
In reply to I'm Sorry » Blah, posted by Blah on January 28, 2003, at 0:03:26
Blah-
I keep hoping somebody will have some words of wisdom to help you through this awful period. I remember (barely) that I was looking for the answer from just about everyone I knew, but words were never enough.I know how alone you feel right now. I felt the same thing. I had also lost all hope and had to hang on with my fingernails. The only 2 reasons I held on were 1) fear of eternal damnation ( a side effect of my religious upbringing) and 2) I knew it would devastate my family.
There's nothing I can say that'll help you out, other than that most of us in this group have felt the same. When I was there, I thought nobody could feel worse than I did. I knew others were depressed but didn't think anyone was THAT depressed. But believe me, there are plenty out there feeling just as bad.
Please, just hang on. You will be glad you did when you finally find your way out of the pit.
If you can gather the strength, call some more docs until you get what you need. any kind of doc, not just pdocs.
Also, ease up on yourself. It's easy to start diagnosing yourself in this frame of mind, and the diagnosis is never good. That's depression at work.
You are not alone, even if you feel like you are.
androog
Posted by blah on January 28, 2003, at 20:21:32
In reply to Re: I'm Sorry, posted by androog on January 28, 2003, at 11:15:15
Thanks, I do appreciate your words, but I do know this diagnosis is correct. I also have depression, dysthymia, anxiety, and probably avoidant personality disorder traits, but I am primarily schizotypal. In a way it's what I've been telling thearapists and doctors ever since I was a child. I just didn't have the right words to explain it, and they were too arragant to both sift through what I was saying, and in some cases to believe me in the first place. No one would believe the trouble I had with physical activities like homework, housework, and exercize were real. I was too inteligent for it to be a learning dissorder. My eccentricity, or as it was usually called, "being weird" was cause for daily torture by my peers at very young ages, and on some level I am avoided, teased, or judged by most people I know to this day. When I was young the teachers and most adults accused me of just trying to get attention, but I was just interacting to only ways I knew how. Now, even after changing my behavior considerably (if only on an intellectual level) people, especially women know there is something fundamentaly wrong. They don't know what it is, they just don't want to be around it. So often I feel like I'm speaking a different language than the people around me. The more I'm alone, and the more my depression builds the more my mind drifts, even when I'm around people now, and all pdocs care about is addiction, and all friends can talk about is selfesteam. Selfesteem doesn't cure disorganized thoughts. Unless some drug works (and it won't be anything conventional) there really isn't any hope for me. I don't have the effort I once had, and ecconomic survival will soon be an omnipresant problem.
I made an appointment with that other pdoc I was talking about. She won't be able to rx opioids right away but maybe in a month or two, and maybe we'll be able to find another source like a pain doctor. I'm just having trouble holding on everything hurts so much, and there is no hope anywhere.
Posted by Luka62 on January 28, 2003, at 22:43:27
In reply to Re: licensed physicians, posted by androog on January 25, 2003, at 11:53:22
I couldn't believe when I read that meds such as valium, ativan, vicodin and ultram could be purchased online. I checked out some of the sites and was astounded! I know the situation some people are in, feeling they have no choice, they can't get their docs to prescribe for them...I may consider the same if I had to, but fortunately I have docs who do prescribe what I need, including pain med.
The prices they charge are outrageous! Sounds like you're paying a price to get the drug off the street. I take the pain med Ultram, which costs about $1.00 a pill for the BrandName, less for generic. Most online pharmacies charge from 3 to 5 times its retail cost.!
I suppose you'd consider you're paying more for "online physician consultation", but who's to say who is really authorizing the requests?
Posted by Luka62 on January 28, 2003, at 23:01:53
In reply to Re: opiates and major depression, posted by androog on January 27, 2003, at 1:49:04
> Watch out for that Nardil! It put me in the hospital hooked up to an EKG, sucking on nitroglycerin. They didn't tell me I couldn't use OTC nasal spray while on Nardil, just that I couldn't eat certain things.
>
> And they think opiates are dangerous!
>
> Glad to hear the Ultram is working for you.
>
Thanks!
I hear you! You should have been informed better about the nasal spray. What sounds benign can be deadly!
In the past I've taken prescribed narcotics not just for pain, but to make life a little more tolerable. However my pdoc doesn't prescribe narcotics for me.(Matter of fact, he lost his position as a superintendant of a state hospital when years back he prescribed a Schedule II drug to a patient who was having trouble kicking a habit.) I think it'll be a long time if ever opiates are used for depression giving the high potential for abuse.
Posted by bozeman on January 28, 2003, at 23:38:56
In reply to Re: I'm Sorry » androog, posted by blah on January 28, 2003, at 20:21:32
Wow . . . Reading your last three or so posts, I am absolutely floored by the similarity between your "stream of consciousness" and that of a dear friend of mine. He too is incredibly intelligent but painfully stymied. Like you, he feels like Stranger in a Strange Land (if you've never read it, the title says enough for you to get the picture.) His entire life he felt like the world was on one sheet of music and he was on another (he's right), that everyone talked about him (actually, they do), and that no one understood him (for a long time, that was true.) Dating women was a disaster. They all expected to one day find out he was an escaped ax murderer, he thinks, and that's probably not far from the truth. That is, until he found the one woman who looked past his "weirdness" and found the shining soul underneath. Yes, he's still different, still doesn't connect with the rest of the world most of the time, but he connects with her when he's able to "come out", and she patiently does her own thing the rest of the time. Most people look at them and wonder what she sees in him, but if you ever really watch the two of them together you know what it is. He treasures and appreciates her for really seeing who he is, and she treasures and appreciates him for letting her be who she is (most men find her intimidating, and I see why they would -- she's tenderhearted but tough as nails.) Often he is on medication, with mixed results at best, often apparently with only side effects and no positive benefit. No matter what side effects or disturbed moods he gets, she just gives him space and supports him from a distance until he lands again. They are actually better together than either is apart, because each gives the other something no on else ever has.
How do I know so much about them? Because she's my sister. And in my opinion, he's better for her than the attorneys and other high-powered types she's dated in the past. I love him for what he does for her -- lets her just be herself, and lets himself need her just the way she is. He doesn't use her, he just needs her strength and calm. And she thrives on that.
My point is the same as androogs: don't give up! There is no way for any of us to tell what tomorrow will bring, even when we are *completely* sure that we know everything there is to know about all the possibilities. There really are good and caring doctors out there, who can help, though I agree you sometimes have to go through three dozen (or more) "know-it-all" ones before you find one who understands that you live in your body, no one else does (we hope :-) and you know what's going on in there better than anyone else could. There are new drugs and new treatments being developed that really do help many people. Unfortunately, you haven't found what works well for you, and a doctor who will support and work with you in finding what works for you, yet. And you may not for a long while. But don't give up, others are here to support you, who know you're suffering terribly. We can't stop the pain or the injustice of it, but we do care.
I'm not trying to give you the glib "everything's going to be alright" speech, because we both know it may not be. But you're smart, articulate (at least in your writing), you're strong, you obviously know a lot about your condition and your own life, and you gotta keep trying.
Sometimes when I felt the absolute, crappiest, scumsucking worst, the only thing I could hold out to myself was, "I'm not gonna give *anyone* the satisfaction of seeing me quit. Not my enemies who think I'm a loser, not the doctors who think I'm a hypochondriac (haven't we all heard that one!), not the damn devil, either. I will go on fighting until the day I die -- of old age -- or get hit by a truck, whichever comes first." You quit, they win!! Don't let them win by forfeit. Sometimes anger was all I could muster, and sometimes I couldn't even manage that. But I couldn't just let them be right about me. I knew my condition was real, not "mental", and if I could just find someone who knew enough to help, I could make it.
I wasted about fifteen years of my life I could have felt like a person instead of a blob of nothing, before I agreed to try medication. You've tried the medication, but not felt the relief. You're understandably frustrated and at your wits end. But please, don't give up. There is hope, however small it seems. You can come here to vent and talk whenever you need to.
I pray that you find some relief and some peace soon, and that your new pdoc will be able to help you get what you need. But even if you have to go through another dozen docs, don't stop trying. I and others here need to hear what you have to say (thoughtful and pointed comments, even if they do come at light speed. We'll keep up. Just you keep talking.)
Sincerely wishing you a better day than you've had --
bozeman
Posted by Mattkit on January 30, 2003, at 20:40:39
In reply to Re: I'm Sorry » blah, posted by bozeman on January 28, 2003, at 23:38:56
Hey Blah
Keep writing, I like reading it and I am learning
from it. I know about the suffering and damn I wished I had the answer. I know about the feeling of desperation and being in a pdocs office that just doesnt get it. I always thought if I was a heroin junky I would want to go to help from someone who has done heroin cause they would have experienced the "feel"' I feel the same way about pdocs, I think alot of them have never had a bad day in their life and their trying to help me.
Dont waste too much time with the bad ones. Ive been there where the only thing keeping me from suicide is my heart,it keeps beating and I have to wake up (if Icould sleep) and go thru the whole shit again. My father is a schizophrenic
my mother the most beautiful person ever in my life died when I was 21. And I am left with a mind that is really screwed up. Im 36 now and have had alot of bad days the few good ones are worth it though. If you ever feel "the rest of the world" is normal dont believe it, the rest of the world is never (very few) happy either they
just deny it and live like shit (the9to5hell).
Be proud of who you are cause from what I have found the "strange people" and the alcoholics, and the drug addicts are the true nice people of this world they just havent figured out how to
get what is due to them while taking care of themselves along the way. Im not a women but I bet
there are a million girls that would rather be with you then their boring boyfriends or husbands
they have now. One thing else I have learned that
its up to me with my screwed up mind to find the answerand so far its a lifelong journey, I make alot of mistakes and I have alot of work to do
but will keep going. I just hope they come out with a I DONT GIVE A FUCK PILL SOON cause when you feel that way you live forever.
Posted by Dr. Bob on January 31, 2003, at 0:42:02
In reply to Re: I'm Sorry, posted by Mattkit on January 30, 2003, at 20:40:39
> I just hope they come out with a I DONT GIVE A xxx PILL SOON cause when you feel that way you live forever.
I'd like as many people as possible to feel supported here, so please don't use language that could offend others:
http://www.dr-bob.org/babble/faq.html#civil
Thanks,
Bob
PS: Follow-ups regarding posting policies, and complaints about posts, should be redirected to Psycho-Babble Administration; otherwise, they may be deleted.
Posted by McPac on January 31, 2003, at 20:32:17
In reply to Crossroads., posted by Blah on January 27, 2003, at 23:18:12
Please send me an e-mail at
Imupacrk@msn.com
Posted by bee happy on February 17, 2003, at 21:25:18
In reply to Re: Buprenorphine-- bee happy, posted by Mattkit on January 27, 2003, at 23:09:58
Hi Matt I am just checking back to see if you had any luck with Buprenorphine trial. I am still doing very well with it and am curious if any others who expressed interest were able to a) find a doctor willin to try it and b) benefit from the trial. I hope you are well. Bee
Posted by SLS on February 18, 2003, at 16:04:13
In reply to Re: Buprenorphine-- bee happy » Mattkit, posted by bee happy on February 17, 2003, at 21:25:18
> Hi Matt I am just checking back to see if you had any luck with Buprenorphine trial. I am still doing very well with it and am curious if any others who expressed interest were able to a) find a doctor willin to try it and b) benefit from the trial. I hope you are well. Bee
Hi Bee.
In what form to you take buprenorphine? How much do you take and how do you schedule your doses?
Have you ever tried Ultram (tramadol)?
Thanks.
- Scott
Posted by bee happy on February 18, 2003, at 18:30:07
In reply to Re: Buprenorphine-- bee happy, posted by SLS on February 18, 2003, at 16:04:13
Hi Scott.Yes I tried Ultram,right before going to the Buprenorphine.It did nothing for me except relieve the achiness I felt while depressed. I am taking a compounded sublingual troche 2mg 4 x's daily. The spacing usually goes something like this 8am,12noon,4pm and 8pm. Ihave gone up as high as 12mg and as low as 6mg. I think it has alot to do with how fast the troches melt under your tongue. Sometimes if my mouth is very watery they melt so fast that alot gets wasted.When that happens I take an extra one.On the other hand if my mouth is dry it seems I feel every bit of the effects. I live in a very warm climate and perhaps the heat has something to do with it. Why do you ask? Are you about to give it a try? Are you one of the very few of us who respond to opiates in such a way that it seems to be the missing link in your chemistry? If so,I wish you lots of luck.It seems that many on this board have had a hard time finding a docotor willing to try this.My doctor is pretty openminded but no pushover. I had to do alot of the research myself. And he monitors me pretty closely but also trusts when I tell him about the inexact sublingual absorbtion. Yes, I am concerned about tolerance and addiction but I am more afraid of going back to way I felt 6 months ago.So, what's your story? Any opiate history? Have you tried all the other families of antidepressants? Bee
Posted by kara lynne on February 18, 2003, at 21:12:13
In reply to Re: Buprenorphine-- bee happy » Mattkit, posted by bee happy on February 17, 2003, at 21:25:18
My doctor said there is a delay in the release of subutex in the US; suboxone has made its debut. Is it legal where you are?
Posted by SLS on February 18, 2003, at 21:16:16
In reply to Re: Buprenorphine-- bee happy » SLS, posted by bee happy on February 18, 2003, at 18:30:07
Hi Bee.
Thanks for your detailed reply.
> So, what's your story?
I suffer from a severe anergic depression that is probably a form of bipolar disorder. Dementia (general definition) is probably the most prominent symptom cluster right now. Without the partial relief I glean from Lamictal + desipramine, I cannot read more than two or three sentences before having to quit or go to sleep. My thoughts are very slow and muddied, and my memory is terrible. The few manic episodes I have had were precipitated by drug intervention. Without an effective treatment, I remain depressed continually. Since 1982 (age 22), I have never experienced a spontaneous remission. The only robust (nearly complete) response to treatment came in 1987 and lasted 9 months. I would most likely be OK today had my doctor at that time not opted to discontinue the drug combination (Parnate + desipramine) due to the emergence of mania. Once the mania was under control using lithium and Klonopin, he decided not to restart the antidepressants. I relapsed within two months. Instead of returning to the previously effective medications, he gave me the newly-approved Prozac to try. I guess it was a new toy. To make a long story short, I have not responded to anything since - not even the original MAOI + TCA combination. It is an unfortunate mistake that some people make to discontinue a particular drug, only to go on to relapse and find that their first exposure to the drug has rendered their brain less responsive to it.
I have been on most of the drugs currently available and many that remain unavailable (foreign and investigational). So, yes, I am very interested to pursue the use of opioids should the next few drug trials I attempt fail.
Among the drugs I have tried are:
Parnate
Nardil
imipramine
desipramine
nortriptyline
amitriptyline
amoxapine
protriptyline
lithium
Depakote
trazodone
Wellbutrin
indalpine
viqualine
Prozac
Paxil
Lamictal
Neurontin
Tegretol
Zyprexa
Risperdal
Effexor
clorgyline
idazoxan
nomifensine
adinazolam
bromocriptine
Cytomel
Synthroid
pemoline
Ritalin
DexedrineI have a list somewhere.
- Scott
Posted by androog on February 18, 2003, at 23:02:04
In reply to Re: Buprenorphine-- bee happy » bee happy, posted by SLS on February 18, 2003, at 21:16:16
hi scott-
i just read your latest post and i have to say that you sure have your thoughts well organized, considering your ailments. it must be tough to keep it that together when you feel as bad as you must.i'm one of the fortunate souls who has responded to tramadol. every day it amazes me how quickly it can drag me out of the hole i wake up in.
stories like yours are really inspirational, since you're still putting up a good fight after all these years. you make me realize i should stop whining so much -- that others have it even worse than i do.
hang in there and keep writing.
androog
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