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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Nigel on April 11, 2000, at 11:07:54
Has anyone used either of these in their depression treatment regimen?
Posted by Greg on April 11, 2000, at 14:09:18
In reply to Fentanyl patch and buprenorphine, posted by Nigel on April 11, 2000, at 11:07:54
Nigel,
I wore the Fentanyl patch for chronic pain following a double disk removal and fusion in my lower back. I believe the Fentanyl is basically synthetic Morphine. I wore them for over a year and it ruined my life. I became heavily addicted to the drug and had to go thru detox to kick it and now have clinical depression and anxiety. I believe I was addicted to it after just a few months.Although its possible, I really can't see a doctor being willing to prescribe Fentanyl for depression. It caused depression for me and the withdrawals from it is a living hell. My doctor told me that the patch was the final option before having a Morphine pump implanted in me.
I don't know anything about buprenorphine, but I'm sure that someone out here can fill you in. But I implore you, don't use the Fentanyl. There are far too many other options for dealing with depression. Let me know if you have any specific questions about it.
Peace,
Greg> Has anyone used either of these in their depression treatment regimen?
Posted by Cam W. on April 11, 2000, at 19:07:25
In reply to Re: Fentanyl patch and buprenorphine (Cam W.?), posted by Greg on April 11, 2000, at 14:09:18
Nigel - Buprenorphine is not used in Canada and I really do not know much about it. I think it is a synthetic opiate being tried in combination with naltrexone for treating opiate addiction (in France). I think it is a mixed agonist (mu receptor)/antagonist (kappa receptor) and naltrexone is a mu antagonist, thus leaving you with a kappa receptor antagonist, similar in action to methadone. Studies have shown that it doesn't work as good in maintenance therapy as methadone. By itself, it was supposed to elicit euphoria like morphine. Also, in combination with benzodiazepines it has caused respiratory depression and death in a number of people in Europe. Also, both fluvoxamine and fluoxetine inhibit it's metabolism.The above I gleaned from abstracts on MEDLINE, but other than that, I really don't know what it is good for. - Cam W.
Posted by saint james on April 13, 2000, at 12:13:32
In reply to Fentanyl patch and buprenorphine, posted by Nigel on April 11, 2000, at 11:07:54
> Has anyone used either of these in their depression treatment regimen?
James here....
I do know a person who is on fentanyl patch for depression, but it seems wise to start at the other end of opioids with the less addictive ones.
james
Posted by Elizabeth on April 14, 2000, at 1:56:52
In reply to Re: buprenorphine , posted by Cam W. on April 11, 2000, at 19:07:25
I've taken buprenorphine and also morphine but not fentanyl. What would you like to know?
Cam made some comments that I can add to:
> Nigel - Buprenorphine is not used in Canada and I really do not know much about it. I think it is a synthetic opiate being tried in combination with naltrexone for treating opiate addiction (in France).
It can't be used with naltrexone; it wouldn't work. (If you add naltrexone to it, you might experience opioid withdrawal symptoms, as well.)
> Studies have shown that it doesn't work as good in maintenance therapy as methadone.
There's an issue about this in the U.S. in regard to tolerability and compliance: people taking methadone for addiction treatment have to get it from special clinics, whereas buprenorphine could be prescribed in a doctor's office. (Methadone can be prescribed in a doctor's office for other indications, e.g. pain.)
> By itself, it was supposed to elicit euphoria like morphine.
Not really, no. Some people find it euphoric when injected, but I suspect it's more on a level with codeine, not morphine.
> Also, in combination with benzodiazepines it has caused respiratory depression and death in a number of people in Europe.
I think if you read up on that you'll find that all the deaths in question resulted from massive doses of benzos -- the amounts used by benzo abusers, not by anxiety patients. (I will also say that the one time I tried Ambien with Buprenex, it packed quite a bit more punch than it does normally.)
> Also, both fluvoxamine and fluoxetine inhibit it's metabolism.
Not fluoxetine so much. I'm not sure if the interaction is clinically significant, anyway. Do you happen to know?
> The above I gleaned from abstracts on MEDLINE, but other than that, I really don't know what it is good for. - Cam W.
It's an antidepressant opioid that has relatively less abuse potential than other opioids.
Posted by Cam W. on April 14, 2000, at 6:22:05
In reply to Re: buprenorphine , posted by Elizabeth on April 14, 2000, at 1:56:52
Elizabeth - Thank you, that's the kind of information I would be looking for. Real life stuff is so much more interesting than journal articles (esp. abstracts). The articles tend to gloss over a drug or make it look like the new "club drug". Thanks again - Cam W.
Posted by Nigel on April 14, 2000, at 10:29:47
In reply to Re: buprenorphine , posted by Elizabeth on April 14, 2000, at 1:56:52
Thanks for all your input. I understand that buprnorphine is a kappa opioid antagonist and a mu agonist. Thus, one would get less respiratory depression and more of the "mu" effect (the mu effect is also found in Vicodin and Fentanyl, whereas in morhine and percocet the kapppa effect predominates). Elizabeth, were you taking the buprnorphine for depression? If so, what else were you taking and did you have a positive result? Thanks again.
Posted by Elizabeth on April 15, 2000, at 16:12:02
In reply to Re: buprenorphine , posted by Nigel on April 14, 2000, at 10:29:47
> Elizabeth, were you taking the buprnorphine for depression? If so, what else were you taking and did you have a positive result? Thanks again.
Yes, I was. It worked very well and very fast, but the side effects were miserable. (Nausea, vomiting, constipation, pruritis, etc.)
I took it with Parnate and also by itself. I took morphine by itself -- I didn't get the nausea from that, but it also didn't work as well. I may not have been using a high enough dose; my therapist says he's prescribed it for depression before but the dose was like 150mg/day.
Posted by Steve on April 19, 2000, at 23:51:20
In reply to Fentanyl patch and buprenorphine, posted by Nigel on April 11, 2000, at 11:07:54
> Has anyone used either of these in their depression treatment regimen?
My doc put me on tramadol to treat depression. I found that it not only wasn't that helpful, but that it took months, and a hospitalization to get off it, and I still am not back to baseline.I wouldn't do it again.
This is the end of the thread.
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