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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 DayByDay on September 23, 2003, at 12:56:48
There are case reports and some research about opiates being effective in treating depression.
As far as OCD goes i´ve heard about Ultram and Morphine being effective.Is morphine a better choice than everyday Ultram consumtion since you only have to take it once a week to treat OCD and there probably not develop any significant tolerance/addiction?
Are there other opiates effective for treatment of OCD?I know withdrawal symptoms and tolerance are individual. When it comes to tolerance some say the tolerance increase after a few weeks while I´ve heard about a friend using it for epilepsy (At least I think it was for epilepsy but don´t try using it against epilepsy because i say so,
i might be wrong, besides i think ít may have negative interaction with some anti-epileptic medicines) Anyway he is on the same dose for 4 years. Maybe it also depends on what you use it for. And I´ve heard about various other versions
as far as tolerance development goes
If you tried it for a longer time - when did (if
it did) start to notice stronger tolerance(OCD and/or depression, would be interesting to hear as many experieces as possible.Also if anyone have had any morphine treatment experieces for OCD and/or depression, i would appritiate if you could tell me how it worked?
It would be of very much help if someone could answer could answer at least one of my questions.
I have a quite problematic treatment-resistant OCD
which severly affects my life-quality-
I´m looking for diffrent alternatives to finaly and hopefully feel at least a moderate improvment of my life quality.
Posted by Ame Sans Vie on September 24, 2003, at 2:22:09
In reply to -------------OPIATES FOR OCD???-------------------, posted by DayByDay on September 23, 2003, at 12:56:48
> There are case reports and some research about opiates being effective in treating depression.
> As far as OCD goes i´ve heard about Ultram and Morphine being effective.
>
> Is morphine a better choice than everyday Ultram consumtion since you only have to take it once a week to treat OCD and there probably not develop any significant tolerance/addiction?Either medication must be taken every day -- at first, the morphine may relieve you of your symptoms for a few days with a single dose, but tolerance develops to that very rapidly. That's why I'm sticking to Ultram (for now) and I'm about to try buprenorphine, since it's a mu-opioid agonist (like morphine, heroin, oxycodone), but also a kappa-opioid agonist. Thus, tolerance is limited with bupe. I just know that if I were to try morphine (or OxyContin, for that matter) as my doctors had suggested months ago, I'd be up to 800mg morphine/day by now... yikes.
> Are there other opiates effective for treatment of OCD?
Most seem to be effective, with the exceptions of the primary kappa-opioid agonists, such as pentazocine. Methadone, oxycodone, hydrocodone, codeine, dihydrocodeine, buprenorphine, Stadol, Talwin, Ultram, Demerol, LAAM, Duragesic -- these have all been shown quite helpful.
> I know withdrawal symptoms and tolerance are individual. When it comes to tolerance some say the tolerance increase after a few weeks while I´ve heard about a friend using it for epilepsy (At least I think it was for epilepsy but don´t try using it against epilepsy because i say so,
> i might be wrong, besides i think ít may have negative interaction with some anti-epileptic medicines) Anyway he is on the same dose for 4 years. Maybe it also depends on what you use it for.That certainly has quite a bit to do with it. When treating chronic pain, of course your dose will rapidly escalate; but if your problem is "simply" that you have an inadequacy within your endogenous opioid system (as so many OCDers seem to), then tolerance may not be an issue.
> And I´ve heard about various other versions
> as far as tolerance development goes
> If you tried it for a longer time - when did > (if
> it did) start to notice stronger tolerance(OCD and/or depression, would be interesting to hear as many experieces as possible.I haven't developed a bit of tolerance to Ultram over three and a half months, which is probably greatly helped by the fact that I take therapeutic doses of Robitussin regularly every day -- the NMDA antagonism that the active ingredient in Robitussin possesses can prevent tolerance or at the very least delay it.
> Also if anyone have had any morphine treatment experieces for OCD and/or depression, i would appritiate if you could tell me how it worked?
I've used morphine before, but found it far inferior to the Ultram. Ultram has a triple mechanism of action, which I think is *very* important.
> It would be of very much help if someone could answer could answer at least one of my questions.
> I have a quite problematic treatment-resistant OCD
> which severly affects my life-quality-
> I´m looking for diffrent alternatives to finaly and hopefully feel at least a moderate improvment of my life quality.I hope this answers some of your concerns. I'm always here if you have any more questions.
Posted by matthhhh on September 24, 2003, at 13:00:20
In reply to Re: -------------OPIATES FOR OCD???------------------- » DayByDay, posted by Ame Sans Vie on September 24, 2003, at 2:22:09
hey ame, so i took ultram with my wellbutrin the other day- felt really sociable but i was still really tense and hyperaware of my appearance at times (my ocd), i think the wellbutrin is just making my anxiety worse, i dont know what my doc is thinking! Ive never seen or heard of a post of wellbutrin working for ocd or anxiety- all seem to say that it makes it worse!
Posted by matthhhh on September 24, 2003, at 13:03:27
In reply to Re: -------------OPIATES FOR OCD???------------------- » DayByDay, posted by Ame Sans Vie on September 24, 2003, at 2:22:09
by the way if this wellbutrin + klonopin combo doesnt work i think im going to try nardil or parnate- do u have any experiences with them? I think they could be a could alternative since they act on serotonin in a different way then the ssris do, so perhaps sedation wont occur
Posted by temoigneur on September 25, 2003, at 17:54:14
In reply to Re: -------------OPIATES FOR OCD???------------------- » DayByDay, posted by Ame Sans Vie on September 24, 2003, at 2:22:09
> > There are case reports and some research about opiates being effective in treating depression.
> > As far as OCD goes i´ve heard about Ultram and Morphine being effective.
> >
> > Is morphine a better choice than everyday Ultram consumtion since you only have to take it once a week to treat OCD and there probably not develop any significant tolerance/addiction?
>
> Either medication must be taken every day -- at first, the morphine may relieve you of your symptoms for a few days with a single dose, but tolerance develops to that very rapidly. That's why I'm sticking to Ultram (for now) and I'm about to try buprenorphine, since it's a mu-opioid agonist (like morphine, heroin, oxycodone), but also a kappa-opioid agonist. Thus, tolerance is limited with bupe. I just know that if I were to try morphine (or OxyContin, for that matter) as my doctors had suggested months ago, I'd be up to 800mg morphine/day by now... yikes.
>
> > Are there other opiates effective for treatment of OCD?
>
> Most seem to be effective, with the exceptions of the primary kappa-opioid agonists, such as pentazocine. Methadone, oxycodone, hydrocodone, codeine, dihydrocodeine, buprenorphine, Stadol, Talwin, Ultram, Demerol, LAAM, Duragesic -- these have all been shown quite helpful.
>
> > I know withdrawal symptoms and tolerance are individual. When it comes to tolerance some say the tolerance increase after a few weeks while I´ve heard about a friend using it for epilepsy (At least I think it was for epilepsy but don´t try using it against epilepsy because i say so,
> > i might be wrong, besides i think ít may have negative interaction with some anti-epileptic medicines) Anyway he is on the same dose for 4 years. Maybe it also depends on what you use it for.
>
> That certainly has quite a bit to do with it. When treating chronic pain, of course your dose will rapidly escalate; but if your problem is "simply" that you have an inadequacy within your endogenous opioid system (as so many OCDers seem to), then tolerance may not be an issue.
>
> > And I´ve heard about various other versions
> > as far as tolerance development goes
> > If you tried it for a longer time - when did > (if
> > it did) start to notice stronger tolerance(OCD and/or depression, would be interesting to hear as many experieces as possible.
>
> I haven't developed a bit of tolerance to Ultram over three and a half months, which is probably greatly helped by the fact that I take therapeutic doses of Robitussin regularly every day -- the NMDA antagonism that the active ingredient in Robitussin possesses can prevent tolerance or at the very least delay it.
>
> > Also if anyone have had any morphine treatment experieces for OCD and/or depression, i would appritiate if you could tell me how it worked?
>
> I've used morphine before, but found it far inferior to the Ultram. Ultram has a triple mechanism of action, which I think is *very* important.
>
> > It would be of very much help if someone could answer could answer at least one of my questions.
> > I have a quite problematic treatment-resistant OCD
> > which severly affects my life-quality-
> > I´m looking for diffrent alternatives to finaly and hopefully feel at least a moderate improvment of my life quality.
>
> I hope this answers some of your concerns. I'm always here if you have any more questions.
>Hey Ames, how are you, hey this is Ben, (temoigneur) here, the last thing in the world I want is for this to come across as smug or antagonistic, but I was just wondering why you are switching to buprenorphine if you haven't gained tolerance to Ultram and it's still working well. I only ask because getting my doctor to try Ultram will be a challenge, I wanted to go with what had the best chance of working right from the start. You seem very knowledgeable about the mechanisms of these drugs, does buprenorphine seem like a better candidate. What about the Ultram leaves room for improvement? Thanks again so much for taking the trouble to answer my q's.
take care, Ben
Posted by Ame Sans Vie on September 26, 2003, at 20:41:58
In reply to Q. for Ame Sans Vie, » Ame Sans Vie, posted by temoigneur on September 25, 2003, at 17:54:14
Really simple actually -- my fibromyalgia pain has been getting worse and worse and now it's to the point that I had to begin seeing a pain-management specialist. He ordered some MRIs and lab work last time and once I bring the negative results back to him, he's switching me onto something that helps with the pain. Ultram doen't do a thing for the pain even in doses of 600mg+.
Posted by temoigneur on September 27, 2003, at 2:43:20
In reply to Re: Q. for Ame Sans Vie, » temoigneur, posted by Ame Sans Vie on September 26, 2003, at 20:41:58
> Really simple actually -- my fibromyalgia pain has been getting worse and worse and now it's to the point that I had to begin seeing a pain-management specialist. He ordered some MRIs and lab work last time and once I bring the negative results back to him, he's switching me onto something that helps with the pain. Ultram doen't do a thing for the pain even in doses of 600mg+.
Hi Michael, I'm so sorry to hear you're in pain, I guess in the final analysis all someone can do from a long distance is try and be of comfort and pray, I'll keep you in my thoughts and prayers - God Bless, and thank you for all your helpful responsesBen
Posted by Ame Sans Vie on September 27, 2003, at 14:06:54
In reply to Re: Q. for Ame Sans Vie,, posted by temoigneur on September 27, 2003, at 2:43:20
Hi Ben,
Thanks so much for your caring, it really means a lot right now. The pain seems [actually *seemed* -- explanation in a moment :-) ] to be emanating from my lower-back -- up to my cheekbones and down to my toes. Anyone who's ever had pain in that area can attest to how incapacitating and, dare I say, depressing it can be and almost invariably is.
I somehow managed to get out of bed and head to Basic Foods today where I was hoping to find some things to help while waiting for my next appointment with the pain doc, and during treatment as well, of course. Among many other things, I've been taking dl-phenylalanine (DLPA) for quite a while now -- it undisputedly has a profound impact on the efficacy of the dextroamphetamine I take. Normally 60mg qid would be the very least I'd require to feel benefit (and even if I were crazy enough to take that much, who would prescribe it?), but with the DLPA, I can reduce it to 30mg qid; with the addition of sodium bicarbonate (GI alkalinization increases effect of dex; urinary alkalinizatino increases duration of effect) I cut my dose down to 15mg tid. QUITE a substantial effect, I'd say!
I'm getting off track, but I just wanted to explain that aspect of the DLPA before I go into my foray at Basic Foods today. The other benefit is that the d-isomer (d-phenylalanine) is an enkephalinase inhibitor -- i.e. it can be considered sort of the "monoamine oxidase" of enkephalin, the endorphin most often implicated in pain relief and feelings of well-being/euphoria. So, just as MAO inhibitors exert their effect by repressing the degredation of serotonin, dopamine, norepinephrine, etc, DPA increases the concentration of enkephalin with the body. Not to mention that both LPA and DPA act upon the dopaminergic system as well, mainly through metabolism to phenylethylamine -- a very close chemical cousin to amphetamine (beta-phenylethylamine) and a neurochemical believed to be involved with feelings of contentment and the state of falling in love. This dopaminergic activity probably also increases endorphin activity in some way or another, though this is purely speculation on my part.
Though I've known for quite some time that DLPA could work beautifully for my pain, depression, lethargy, etc. ad nauseam, I'm unable to take doses exceeding 1,500mg daily because of overstimulation. I assumed this was due to the l-isomer, since (if I recall correctly), it is said to be the more stimulating of the two. Well, I assumed correctly. I had no clue that DPA was available on its own until I made sure to scan all FOUR huge aisles of supplements/remedies (four aisles...... my gods, I love that store, lol). I had looked in the past, assuming it would be alongside the LPA capsules, LPA powder, DLPA capsules, and the rest of the amino acids. Well, I ended up finding it in the considerably large "Mood/Neuro-Enhancement" section (they even carry picamilon now -- $7.48 per 90 capsules, 100mg each!!!! I normally pay $30 + S&H for 60 capsules!). The DPA was in a product they had labeled as a new item, under the name "EndorphiGen", 500mg capsules, 50 count for $15. After all the research I've perused [and, admittedly being enticed by the name "EndorphiGen" -- great marketing tactic ;-) ], I readily bought four bottles.
That's not the end of it, though, by far. I've been looking for legal, well-studied GHB alternatives (i.e. human growth hormone [hGH] secretalogues with pain-killing and sleep enhancement properties). I've recently found some things that work very well (e.g. Invigorate II, Liquid Relaxation, Renew G, Renew G PM), but I'm legitimately concerned about their safety due to the mysterious ingredients (espeicially in Invigorate II -- active ingredient is kryokova, but no one can figure out what the hell it is!). There hasn't been enough (or any) research on most of these ingredients, which makes me a bit uneasy. How lucky was I to just be casually browsing the store and notice a product called "HMB", manufactured by Optimum Nutrition. It was in the body-building supplement section, so immediately my mind made the connection -- HMB:GHB. I picked up the bottle to review the ingredient(s) and was ecstatic to see the words "calcium beta-Hydroxy beta-methylbutyric acid", which seems awfully close to GHB's full name, "gamma-hydroxybutyric acid" (also sold originally as a fitness supplement). In my mind, I used that IUPAC name of HMB to compare the molecular structures of HMB and GHB and grew pretty excited. GHB's structure and formula are:
HO-CO-(CH2)3-OH
C4H8O3And HMB:
CH3-C2H4O-CH2-COOH
C5H10O3Naturally I snatched this one up right away, despite it being rather pricey ($30 per 90 capsules, 500mg each -- a two week supply).
I also picked up a couple bottles of Valerian-Poppy tincture, manufactured by GAIA herbs and a bottle of l-tryptophan, 60 capsules 500mg.
Upon returning home, I took 750mg DLPA, one gram DPA, 500mg l-tryptophan, one gram HMB, and 1ml Valerian-Poppy tincture. Get this.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
.........
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.........
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.........NO~~~~~~~~~~~~MORE~~~~~~~~~~~~PAIN!
:-DDDDDDDDDDD
Unfortunately, I can't afford this all the time, so I'll still have to see the pain doc (buprenorphine, OxyContin, Oramorph-SR, Dilaudid... I could care less), but I'm pretty darn sure I'm sticking with the DPA and HMB.
Posted by matthhhh on September 27, 2003, at 14:14:34
In reply to Re: Q. for Ame Sans Vie, » temoigneur, posted by Ame Sans Vie on September 27, 2003, at 14:06:54
Hey Ame, so this herbal combo that you took that relieved your pain, did it do anything for your anxiety and ocd. Ive taken DLPA before and out of all the amino acids and herbal supplements its the one that i really noticed an effect and some benefit from. i get it from vitamin shop, like $25 for 300, 500mg caps.
Im just placed an order for tryptophan from that GP site. Where did u get yours?
Posted by Jasmine Neroli on September 27, 2003, at 16:22:20
In reply to Re: Q. for Ame Sans Vie, » temoigneur, posted by Ame Sans Vie on September 26, 2003, at 20:41:58
Hi Michael:
I was just reading this thread for interest and education, but when I read your post about all your physical pain (as well as the mental health issues I already knew about) I felt it necessary to tell you how strong you have been and how determined you are to solve your problems! You are amazing! I know this isn't the "support" board, but I want to give u mine , at this point. You have encouraged me in the past, over medication issues, so now it's my turn!!!
Take care and keep on :)
Jas
P.S. I'm still trying to find the right combo of meds for my anxiety, which is increasing again. For some reason, I am making poor life decisions lately, and taking dumb risks, which is then creating more anxiety. I don't even know myself anymore...my whole personality/value systems seem to have changed over the course of the past 2 years of GAD (or whatever I've got). Buspar (20mg) per day has not kicked in yet (after 2 weeks) and I still need to add Klonopin to survive somedays....even tho' my psych wants me tapering off, to see if Buspar will work. Don't you feel like it's a never-ending circle??? Ha!
I'm gonna go listen to NIN "Downward Spiral", paradoxically, I think it will help!
Posted by DayByDay on September 27, 2003, at 17:56:54
In reply to Re: Q. for Ame Sans Vie,, posted by Jasmine Neroli on September 27, 2003, at 16:22:20
My whole personality/value systems have changed
a lot too since my last severe depressive/OCD + a lot anxiety period, I know the feeling, my future probably won´t be what I wanted it to be but I have make the best of what I got I, maybe their was a reason for it, who knows, all kinds of stuff happens to people,
Really hope you find you anxiety med, I have had
periods of severy allday long anxiety and I know how painful it can be.DbD
Posted by Ame Sans Vie on September 28, 2003, at 3:11:58
In reply to Re: Q. for Ame Sans Vie,, posted by matthhhh on September 27, 2003, at 14:14:34
Well, my anxiety, OCD, ADD, etc. are already well-addressed with medication. Can't improve perfection. :-)
I definitely notice a ***WONDERFUL*** mood increase from the DPA, and I must say it's subjective effects are unbelievably reminiscent of those provided by... hmm... 25mg hydrocodone + 1,200mg meprobamate. There are no side effects (i.e. nodding, itching, drowsiness, euphoria to the point of incapacitation). Now, this is just my experience, but I am absolutely amazed not only at its potency as a euphoriant/analgesic, but I also am in shock re: its duration of action. I don't recall exactly what time I took the DPA, but it's been at the very least 13 hours (probably closer to 14 or 15) and it's still going strong!
Posted by Ame Sans Vie on September 28, 2003, at 3:22:27
In reply to Re: Q. for Ame Sans Vie,, posted by Jasmine Neroli on September 27, 2003, at 16:22:20
> Hi Michael:
> I was just reading this thread for interest and education, but when I read your post about all your physical pain (as well as the mental health issues I already knew about) I felt it necessary to tell you how strong you have been and how determined you are to solve your problems! You are amazing! I know this isn't the "support" board, but I want to give u mine , at this point. You have encouraged me in the past, over medication issues, so now it's my turn!!!
> Take care and keep on :)
> JasHiya!!
Thank you so, so much -- all the encouragement certainly means a great deal to me. :-)
> P.S. I'm still trying to find the right combo of meds for my anxiety, which is increasing again. For some reason, I am making poor life decisions lately, and taking dumb risks, which is then creating more anxiety. I don't even know myself anymore...my whole personality/value systems seem to have changed over the course of the past 2 years of GAD (or whatever I've got).
Oh, believe me, I can relate to that like no one else. Hardly a thing about me has remained untouched and intact since the illnesses set in. It's sickening to think of... but I'm working on it, and I know I'm making progress because my grandmother (who lives 1,300 miles away) spoke with me on the phone the other day for a few moments, then when I handed to the phone to my mom, my grandma told her, "Now *that's* the Mike I remember!" She (and the rest of my mother's family) is in southwest PA, and I moved from there to here in southeast TX seven years ago.
> Buspar (20mg) per day has not kicked in yet (after 2 weeks) and I still need to add Klonopin to survive somedays....even tho' my psych wants me tapering off, to see if Buspar will work. Don't you feel like it's a never-ending circle??? Ha!
> I'm gonna go listen to NIN "Downward Spiral", paradoxically, I think it will help!Hmm, now that you've used a benzodiazepine, chances are that BuSpar won't be helpful for you... statistically speaking. But the dosage of BuSpar can be pushed far higher with very few (and quite often no) side effects.
Oh, and I LOOOOOOOVE 'The Downward Spiral'! :-) Hurt is such a beautiful song... and of course it's hard to beat Closer. ;-)
Posted by Ame Sans Vie on September 28, 2003, at 3:30:15
In reply to Re: Q. for Ame Sans Vie,, posted by matthhhh on September 27, 2003, at 14:14:34
Sorry, forgot your question about where I got my supps. I just picked them up at the health store yesterday -- expensive, but convenient, lol.
DPA -- $29.95 - 90 capsules, 750mg/cap
L-Tryp -- $39.95 - 120 capsules, 1,000mg/cap
Posted by jparsell82 on September 28, 2003, at 10:03:44
In reply to Re: Q. for Ame Sans Vie, » matthhhh, posted by Ame Sans Vie on September 28, 2003, at 3:30:15
You can get DPA for $16(500mg) here:
Posted by Dr. Bob on September 28, 2003, at 20:44:56
In reply to Re: Q. for Ame Sans Vie,, posted by jparsell82 on September 28, 2003, at 10:03:44
> You can get DPA for $16(500mg) here:
>
> http://store.yahoo.com/iherb/bes.htmlSorry to interrupt, but I'd like to redirect discussion about alternative treatments to the new Psycho-Babble Alternative board. Here's a link:
http://www.dr-bob.org/babble/alter/20030903/msgs/264124.html
Thanks,
Bob
This is the end of the thread.
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