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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by Else on July 14, 2001, at 14:18:43
For a long time I assumed it was Stadol but that's buterphanol. What is buphrenorphine? I've never heard of it.
Posted by shelliR on July 14, 2001, at 20:27:05
In reply to What is buprenorphine?, posted by Else on July 14, 2001, at 14:18:43
> For a long time I assumed it was Stadol but that's buterphanol. What is buphrenorphine? I've never heard of it.
Else, your best bet for an answer is to search, "Buprenorphine" on this board. You'll get back all of the threads related to its discussion. For more information, do a web search on it. Then if you have any questions, you might bring those back to this board.
Shelli
Posted by Elizabeth on July 15, 2001, at 17:33:32
In reply to What is buprenorphine?, posted by Else on July 14, 2001, at 14:18:43
> For a long time I assumed it was Stadol but that's buterphanol. What is buphrenorphine? I've never heard of it.
OK, so, there are 3 different subtypes of opioid receptors: mu, kappa, and delta. (sigma turned out not to be an opioid receptor) Stadol is a kappa agonist (meaning it selectively activates kappa-type opioid receptors) and partial mu antagonist (meaning there's a ceiling on its intrinsic effect at these receptors).
Buprenorphine is a partial mu agonist and kappa antagonist. In the US, it's sold in an injectible solution under the brand name Buprenex (there's also at least one generic available, but it's still expensive). In some other countries it's available in a sublingual tablet called Temgesic or Subutex.
A sublingual formulation which would contain both buprenorphine and naloxone (the latter is to prevent people from melting & injecting it) is under investigation in the US as a treatment for opioid dependence.
There used to be a similar sort of drug, dezocine (Dalgan), but that got taken off the market.
-elizabeth
Posted by Else on July 17, 2001, at 22:28:28
In reply to Re: What is buprenorphine? » Else, posted by Elizabeth on July 15, 2001, at 17:33:32
Very strange. In the U.S. people seem to have a lot more choices than here (Canada). I have never heard of an opiate being used for depression. And I don't know any adult who takes a major stimulant for ADD although schoolchildren have no trouble getting scripts. There are other drugs like Provigil and the like that are unavaillable as far as I know and I've never heard of stimulants being used as augmentation therapy for depression. Maybe because most of the research is done in the US and also there's the state run drug insurance which tends to limit choices.
> OK, so, there are 3 different subtypes of opioid receptors: mu, kappa, and delta. (sigma turned out not to be an opioid receptor) Stadol is a kappa agonist (meaning it selectively activates kappa-type opioid receptors) and partial mu antagonist (meaning there's a ceiling on its intrinsic effect at these receptors).
>
> Buprenorphine is a partial mu agonist and kappa antagonist. In the US, it's sold in an injectible solution under the brand name Buprenex (there's also at least one generic available, but it's still expensive). In some other countries it's available in a sublingual tablet called Temgesic or Subutex.
>
> A sublingual formulation which would contain both buprenorphine and naloxone (the latter is to prevent people from melting & injecting it) is under investigation in the US as a treatment for opioid dependence.
>
> There used to be a similar sort of drug, dezocine (Dalgan), but that got taken off the market.
>
> -elizabeth
Posted by Elizabeth on July 18, 2001, at 8:34:49
In reply to Re: What is buprenorphine? » Elizabeth, posted by Else on July 17, 2001, at 22:28:28
> Very strange. In the U.S. people seem to have a lot more choices than here (Canada). I have never heard of an opiate being used for depression.
It's not common. My hope is that it will become an accepted treatment in the future.
> And I don't know any adult who takes a major stimulant for ADD although schoolchildren have no trouble getting scripts.
That's more surprising. I would have expected Canada to be less backward than the USA about something like this.
> There are other drugs like Provigil and the like that are unavaillable as far as I know and I've never heard of stimulants being used as augmentation therapy for depression.
I think you have a couple things that we don't, too.
> Maybe because most of the research is done in the US and also there's the state run drug insurance which tends to limit choices.
Maybe, although the US Food and Drug Administration makes it *very* hard to get new drugs approved.
-elizabeth
Posted by Else on July 18, 2001, at 14:10:25
In reply to Re: What is buprenorphine? » Else, posted by Elizabeth on July 18, 2001, at 8:34:49
I don't know. The only psychiatric drug we have access to that Americans don't is Manerix as far as I know. I once asked my pdoc if I could try it. He said it's useless in small doses and as dangerous as other MAOIs in higher doses. Of course that's his opinion. I think doctors here tend to go by the book. Adult ADD patients will often get Desipramine or Wellbutrin as first-line treatment because they don't carry the stigma associated with major stimulants and I don't think most drugstores even carry Dexedrine. Only cancer patient would get something like Vicodin, for instance. And you would be surprised to see how willing to kiss the FDA's ass the Canadian government is. They don't want to make trouble you see.
> > Very strange. In the U.S. people seem to have a lot more choices than here (Canada). I have never heard of an opiate being used for depression.
>
> It's not common. My hope is that it will become an accepted treatment in the future.
>
> > And I don't know any adult who takes a major stimulant for ADD although schoolchildren have no trouble getting scripts.
>
> That's more surprising. I would have expected Canada to be less backward than the USA about something like this.
>
> > There are other drugs like Provigil and the like that are unavaillable as far as I know and I've never heard of stimulants being used as augmentation therapy for depression.
>
> I think you have a couple things that we don't, too.
>
> > Maybe because most of the research is done in the US and also there's the state run drug insurance which tends to limit choices.
>
> Maybe, although the US Food and Drug Administration makes it *very* hard to get new drugs approved.
>
> -elizabeth
Posted by MB on July 18, 2001, at 14:47:35
In reply to Re: What is buprenorphine?, posted by Else on July 18, 2001, at 14:10:25
> I don't know. The only psychiatric drug we have access to that Americans don't is Manerix as far as I know. I once asked my pdoc if I could try it. He said it's useless in small doses and as dangerous as other MAOIs in higher doses. Of course that's his opinion. I think doctors here tend to go by the book. Adult ADD patients will often get Desipramine or Wellbutrin as first-line treatment because they don't carry the stigma associated with major stimulants and I don't think most drugstores even carry Dexedrine. Only cancer patient would get something like Vicodin, for instance. And you would be surprised to see how willing to kiss the FDA's ass the Canadian government is. They don't want to make trouble you see.
If it feels good, it's the Devil. Protastantism (the philosophy this nation is predicated on) is the paranoia that someone, somewhere, might be feeling good.
Posted by Else on July 18, 2001, at 19:06:02
In reply to Re: What is buprenorphine?, posted by MB on July 18, 2001, at 14:47:35
Well, you know, Canada has more catholics than
protestants (by a hair) but I guess we're just being good neighbourghs. Catholics are o.k. with evil because you can just go to confession afterwards anyway. As for me, I'd rather stay away from both religions, it's better for my precarious mental health. North America sucks.
> > I don't know. The only psychiatric drug we have access to that Americans don't is Manerix as far as I know. I once asked my pdoc if I could try it. He said it's useless in small doses and as dangerous as other MAOIs in higher doses. Of course that's his opinion. I think doctors here tend to go by the book. Adult ADD patients will often get Desipramine or Wellbutrin as first-line treatment because they don't carry the stigma associated with major stimulants and I don't think most drugstores even carry Dexedrine. Only cancer patient would get something like Vicodin, for instance. And you would be surprised to see how willing to kiss the FDA's ass the Canadian government is. They don't want to make trouble you see.
>
> If it feels good, it's the Devil. Protastantism (the philosophy this nation is predicated on) is the paranoia that someone, somewhere, might be feeling good.
Posted by Elizabeth on July 18, 2001, at 20:37:56
In reply to Re: What is buprenorphine?, posted by Else on July 18, 2001, at 14:10:25
> I don't know. The only psychiatric drug we have access to that Americans don't is Manerix as far as I know. I once asked my pdoc if I could try it. He said it's useless in small doses and as dangerous as other MAOIs in higher doses.
That's consistent with the more general rumor that I've heard: that it rarely works (kind of like BuSpar).
> I think doctors here tend to go by the book.
Doctors everywhere do. Britain seems to be particularly bad in that way.
> Adult ADD patients will often get Desipramine or Wellbutrin as first-line treatment because they don't carry the stigma associated with major stimulants and I don't think most drugstores even carry Dexedrine.
Wow. MAOIs might need to be special-ordered, and buprenorphine definitely would (in the US it's only available as a solution intended for injection, so it's mainly used in hospitals). But *Dexedrine*?
France and Switzerland have a lot of drugs that the rest of us don't. Maybe something about English makes people in countries where it's the primary language so uptight. < g >
> Only cancer patient would get something like Vicodin, for instance.
You realise, of course, that as a consequence, Canadians can expect to die in pain.
> And you would be surprised to see how willing to kiss the FDA's ass the Canadian government is.
No I wouldn't. The US puts a lot of pressure on other countries to participate in our "war on [some] drugs."
> They don't want to make trouble you see.
One of the questionable virtues of "neutrality."
-elizabeth
Posted by Elizabeth on July 18, 2001, at 20:39:14
In reply to Re: What is buprenorphine?, posted by MB on July 18, 2001, at 14:47:35
> If it feels good, it's the Devil. Protastantism (the philosophy this nation is predicated on) is the paranoia that someone, somewhere, might be feeling good.
I think we've forgotten the values that the USA was founded on (which aren't Calvinistic ones).
-elizabeth
Posted by MB on July 18, 2001, at 21:20:13
In reply to Re: What is buprenorphine?, posted by Else on July 18, 2001, at 19:06:02
> Well, you know, Canada has more catholics than
> protestants (by a hair) but I guess we're just being good neighbourghs. Catholics are o.k. with evil because you can just go to confession afterwards anyway. As for me, I'd rather stay away from both religions, it's better for my precarious mental health. North America sucks.Yeah, that is one of the overiding benifits of Catholicism (the confessions), and you have all those saints to pray to when God is really busy.
> > If it feels good, it's the Devil. Protastantism (the philosophy this nation is predicated on) is the paranoia that someone, somewhere, might be feeling good.You know, I shouldn't speak depricatingly about a religion. That's not cool. I apologise to anyone whom that that offended. I should take a lesson from the principles of Christianity and be more kind and understanding.
Posted by MB on July 18, 2001, at 21:21:57
In reply to Re: What is buprenorphine? » MB, posted by Elizabeth on July 18, 2001, at 20:39:14
> > If it feels good, it's the Devil. Protastantism (the philosophy this nation is predicated on) is the paranoia that someone, somewhere, might be feeling good.
>
> I think we've forgotten the values that the USA was founded on (which aren't Calvinistic ones).
>
> -elizabethYeah, you're right...didn't mean to get into bashing (whether it be religion or the USA). My apologies, I have anger attacks sometimes. Not an excuse, by any means...just an explaination. Peace.
Posted by Elizabeth on July 19, 2001, at 12:31:24
In reply to Re: What is buprenorphine?, posted by Else on July 18, 2001, at 19:06:02
> Catholics are o.k. with evil because you can just go to confession afterwards anyway.
< vbg >
Protestants confess, too; they just do it in prayer instead of going through a priest. But anyway, for whatever reason, Western countries that are heavily Catholic, like France and Italy, seem to be more progressive than more Protestant (like Britain, the US, Canada, Australia, and New Zealand -- the English-speaking ones).
> As for me, I'd rather stay away from both religions, it's better for my precarious mental health.
I'll second that.
-elizabeth
Posted by Elizabeth on July 19, 2001, at 12:33:33
In reply to Re: What is buprenorphine? » Elizabeth, posted by MB on July 18, 2001, at 21:21:57
> > I think we've forgotten the values that the USA was founded on (which aren't Calvinistic ones).
>
> Yeah, you're right...didn't mean to get into bashing (whether it be religion or the USA). My apologies, I have anger attacks sometimes. Not an excuse, by any means...just an explaination. Peace.I wasn't criticising you at all; I was commenting on how far the US has veered from the values expressed in the Constitution.
-elizabeth
Posted by MB on July 19, 2001, at 19:55:15
In reply to Re: What is buprenorphine? » MB, posted by Elizabeth on July 19, 2001, at 12:33:33
> > > I think we've forgotten the values that the USA was founded on (which aren't Calvinistic ones).
> >
> > Yeah, you're right...didn't mean to get into bashing (whether it be religion or the USA). My apologies, I have anger attacks sometimes. Not an excuse, by any means...just an explaination. Peace.
>
> I wasn't criticising you at all; I was commenting on how far the US has veered from the values expressed in the Constitution.
>
> -elizabethAh, yes...like the right to do with our own bodies as we please. I think people should be held accountable and punished for crimes they commit on drugs (e.g. robberies, murders, child neglect, etc.) just as people are who aren't on drugs. But for the drug taking, itself, to be a crime seems, to me, to be ludicrous.
Posted by Elizabeth on July 19, 2001, at 23:08:54
In reply to Re: What is buprenorphine? » Elizabeth, posted by MB on July 19, 2001, at 19:55:15
> Ah, yes...like the right to do with our own bodies as we please. I think people should be held accountable and punished for crimes they commit on drugs (e.g. robberies, murders, child neglect, etc.) just as people are who aren't on drugs. But for the drug taking, itself, to be a crime seems, to me, to be ludicrous.
Yes, that's how I feel too. (Similarly, I don't think people should be punished for "hate crimes" more than someone who committed the same crime for other reasons would be.)
-elizabeth
This is the end of the thread.
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