![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by fairywings on March 15, 2006, at 0:57:52
I noticed after my last couple of migraines, that if I took Vicodin I wasn't as prone to get ticked off at my kids when they're doing things that annoy me - like fighting and then carrying on excessively.
So, yesterday and today I was a bit depressed, pms-ing and really irritable, but didn't have a migraine. I took Vicodin to see what it would do for me, and I was calm and not irritable at all.
I've been more depressed and more irritable lately, but I'm not on an anti-depressant right now. Is there an anti-depressant that will make me less depressed and less irritable, but not sleepy or lethargic, help with the irritability, not affect my cognitive abilities, and not cause weight gain? Ah, the perfect med. right?
Should I tell my pdoc what the Vicodin did for me, or would taking it when I didn't have a migraine be a no-no? I mean rationally, I know I shouldn't take it when I don't have a migraine, but does it help to know it affected my mood like that? I'd hate to lose the one thing that really helps when I have a raging migraine.
Any thoughts?
fw
Posted by TylerJ on March 15, 2006, at 8:47:49
In reply to Vicodin questions............, posted by fairywings on March 15, 2006, at 0:57:52
> I noticed after my last couple of migraines, that if I took Vicodin I wasn't as prone to get ticked off at my kids when they're doing things that annoy me - like fighting and then carrying on excessively.
>
> So, yesterday and today I was a bit depressed, pms-ing and really irritable, but didn't have a migraine. I took Vicodin to see what it would do for me, and I was calm and not irritable at all.
>
> I've been more depressed and more irritable lately, but I'm not on an anti-depressant right now. Is there an anti-depressant that will make me less depressed and less irritable, but not sleepy or lethargic, help with the irritability, not affect my cognitive abilities, and not cause weight gain? Ah, the perfect med. right?
>
> Should I tell my pdoc what the Vicodin did for me, or would taking it when I didn't have a migraine be a no-no? I mean rationally, I know I shouldn't take it when I don't have a migraine, but does it help to know it affected my mood like that? I'd hate to lose the one thing that really helps when I have a raging migraine.
>
> Any thoughts?
> fw
Vicodin is hydrocodone/acetaminophen, an Opiod agonist w/tylenol. Too much Tylenol is very hard on the Liver...some people have died fom tylenol alone because of Liver shutdown.
Vicodin binds to opiate receptors in the CNS. It can cause euphoria, sedation, hallucinations, confusion, dysphoria, Physical dependence, psychological dependence, and Tolerance. These are just some of the reasons they should not be used on a daily basis for Depression. Or any thing else for that matter.
Me personally, I love the way they make me feel too. But other Drugs also make me feel very good...alcohol, but alcohol isn't a good drug to use for depression...it can cause depression. It used to be my drug of choice, it worked great for my depression, ocd, anxiety and social phobia until I became a full blown alcoholic and I almost lost my wife and my children. And if I ever got a chance I also abused hydrocodone, again it caused family problems and increased my depression when I was coming off of them. First one pill did the trick, then 2, 3, 4, etc. Tolerance big time. Anyway, this is just my opinion and others here are going to disagree I'm sure. And by the way I 've been clean and sober fo 2 yrs. :)Great for pain, but for clinical depression it is a dead-end!
Tyler
Posted by fairywings on March 15, 2006, at 9:33:32
In reply to Re: Vicodin questions............ » fairywings, posted by TylerJ on March 15, 2006, at 8:47:49
Thanks Tyler,
In the back of my mind, I knew you were right. I"m so sorry you lost your family to alcohol, that's so sad. My dad was an alcoholic, so I know the damage it can do, and it's also why I knew I was probably rationalizing the use of Vicodin.
Guess I'll go have a good run, and try to kick in the endorphins.
I'm glad you've been able to be sober, I admire that, good job.
Thanks,
fw
Posted by john berk on March 15, 2006, at 9:36:35
In reply to Re: Vicodin questions............ » fairywings, posted by TylerJ on March 15, 2006, at 8:47:49
Hi Tyler, you and i seem to share all the same diagnoses, plus i am also a recovering alcoholic, only 1 month at the moment, [i had a 3 day relapse, now on campral]but i had 1 year before that. i have a full bottle of vicodin on my dresser from my last dentist appointment, i know from what others have told me that it is a nice mellowing drug, but with my addictive personality, i would never even try one, thanks for verifying the abuse potential of vicodin
and congragulations on your 2 years sober, quite an accomplisment...john
Posted by john berk on March 15, 2006, at 9:40:37
In reply to Re: Vicodin questions............ » TylerJ, posted by fairywings on March 15, 2006, at 9:33:32
Hi FW,
have a great run, i'm about to do my morning walk, i'm also a runner and lifter, it is an excellent way to deal with depression, i hope you have a great day....john
Posted by Phillipa on March 15, 2006, at 19:56:07
In reply to Vicodin questions............, posted by fairywings on March 15, 2006, at 0:57:52
Fairywings I noticed the same thing after my minor surgery when I was on Percocet my mood was much better. Love Phillipa
Posted by jerrympls on March 16, 2006, at 3:02:43
In reply to Re: Vicodin questions............ » fairywings, posted by TylerJ on March 15, 2006, at 8:47:49
>
> Great for pain, but for clinical depression it is a dead-end!
>
> TylerI'll have to disagree with you Tyler. My doctor has me on hydrocodone 5mg 4x daily along with my other meds for depression. There ARE studies out there supporting the use of opiates in treatment-resistant cases. I've been on hydrocodone (the opiate part of Vicodin) for 18 months now. No tolerance. No abuse. No change in dosage. This is actually a typical response from those on opiates w/ treatment-resistant depressions.
Take a look at this:
http://opioids.com/naloxone/depcrf.html
----------------------------
The effect of naloxone on adrenocorticotropin and cortisol release: evidence for a reduced response in depression
by
Burnett FE, Scott LV, Weaver MG, Medbak SH, Dinan TG
Department of Psychological Medicine,
The Medical Colleges of St. Bartholomew's
and the Royal London Hospitals,
West Smithfield, UK.
J Affect Disord 1999 Jun; 53(3):263-8ABSTRACT
BACKGROUND: Endogenous opioid peptides inhibit the hypothalamic-pituitary-adrenal (HPA) axis by influencing the release of hypothalamic corticotropin releasing factors. This study examines whether increased activity of the HPA axis in major depression is associated with reduced opioid tone. METHODS: We measured the adrenocorticotropin (ACTH) and cortisol responses to an intravenous bolus of naloxone 0.125 microg/kg in 13 depressed outpatients and 13 healthy volunteers. RESULTS: The mean cortisol response was significantly reduced (P<0.05), and the ACTH response was also non-significantly reduced in the depressed subjects. CONCLUSIONS: These findings imply that the degree of inhibitory endogenous opioid tone is reduced in depression. Various mechanisms for the finding are discussed, including possible alteration in the function of alpha-adrenergic pathways. CLINICAL IMPLICATIONS: Reduced endogenous opioid tone may explain why some depressed individuals self-medicate with opiates, and depression is associated with opiate withdrawal. Opioid pathways may have a role in the mechanism of action of antidepressant drugs, and may be of relevance in the development of novel antidepressants. LIMITATIONS OF THE STUDY: The sample size was small, leading to a failure of the difference of the basal cortisol levels and also the delta ACTH between the groups to reach statistical significance.
-----------------------
Now don't misunderstand me -I'm not advocating opiate therapy as a first-line therapy by ANY means. However, one cannot generalize that all "addicitive" medications will ultimately briing out the "addicit" in all of us - no matter what. This is not true. Not all people who drink alcohol are alcoholics - correct?
I believe that "fairywing's" positive antidepressant repsonse to Vicodin is an important clue that points to other models of depressive response that do NOT include the basic - overused and over-simplfied model of "serotonin-imbalance." These "other" models include imbalnces in the HPA axis/cortisol levels/hormonal balances, etc.
I believe we have to accept that an imbalance in serotonin most likely is the RESULT of imblances within other neural-hormonal systems within the brain.
I don't mean to negate anything you are saying - or disrepect you - or preach - I just wanted to post my experiences.
Thanks
Jerry
Posted by jerrympls on March 16, 2006, at 3:19:16
In reply to Vicodin questions............, posted by fairywings on March 15, 2006, at 0:57:52
> I noticed after my last couple of migraines, that if I took Vicodin I wasn't as prone to get ticked off at my kids when they're doing things that annoy me - like fighting and then carrying on excessively.
>
> So, yesterday and today I was a bit depressed, pms-ing and really irritable, but didn't have a migraine. I took Vicodin to see what it would do for me, and I was calm and not irritable at all.
>
> I've been more depressed and more irritable lately, but I'm not on an anti-depressant right now. Is there an anti-depressant that will make me less depressed and less irritable, but not sleepy or lethargic, help with the irritability, not affect my cognitive abilities, and not cause weight gain? Ah, the perfect med. right?
>
> Should I tell my pdoc what the Vicodin did for me, or would taking it when I didn't have a migraine be a no-no? I mean rationally, I know I shouldn't take it when I don't have a migraine, but does it help to know it affected my mood like that? I'd hate to lose the one thing that really helps when I have a raging migraine.
>
> Any thoughts?
> fwYes - I'd share your Vicodin/antidepressant experience with your psychiatrist - IF he/she has somewhat of an open mind. Hard to tell sometimes. But if your doc keeps up on studies, publications, etc relating to newer approaches to the causes and treatments of depressive disorders then he/she WOULD know that opiates ARE used in severe treatment-resistant cases with great success. I'm am one of those successes. Luckily I had a psych. doc at a big teaching hospital/university so approaches to the use of novel treatments for depression weren't scoffed at.
My doc added hydrocodone to my other meds about 8 months ago and it has worked very well. I have had no problems with tolerance, addiction or abuse of any kind and I come from 2 alcoholic parents.
The antidepressant/anti-anxiety response you got from the Vicodin is not uncommon amongst those with depressive disorders. Depression is not just serotonin and norepinephrine - but also cortisol, hormones and opioid related. It's tough to find any good published studies on the use of opiates for depression - mainly because of our fear of "feel-good" pills. Celebrities and the media have done a great job of demonizing opiates -blaming the opiates for their addiction. But I digress. Studies CAN be found and are being increasingly published. We must stop the nonsense that any substance that makes us feel good is inherently bad. NOT that I am suggesting cocaine, crack, etc., be legalized or used for mental disorders - but certain medications - including opiates DO have their place.
Although my experience with an opiate for depression treatment has been a positive one, it is certainly *not* a panacea by any means. It's a crude way to alter our endogenous opioid systems so that they will then bring balance to other connected systems that contribute to depressive disorders. I have no doubt that therapies involving the opioid system are being studied as we speak. They were at the university where I saw my psychiatrist.
I do NOT recommend self-medicating with opiates or using an opiate as a first-line treatment for depression or anxiety - however, I am saying that your response is noteworthy.
I hope that you are able to discuss this with your doctor and that you both can find a suitable treatment that works.
Jerry ;-)
Posted by TylerJ on March 16, 2006, at 9:57:01
In reply to Re: Vicodin questions............ » TylerJ, posted by jerrympls on March 16, 2006, at 3:02:43
>
> >
> > Great for pain, but for clinical depression it is a dead-end!
> >
> > Tyler
>
> I'll have to disagree with you Tyler. My doctor has me on hydrocodone 5mg 4x daily along with my other meds for depression. There ARE studies out there supporting the use of opiates in treatment-resistant cases. I've been on hydrocodone (the opiate part of Vicodin) for 18 months now. No tolerance. No abuse. No change in dosage. This is actually a typical response from those on opiates w/ treatment-resistant depressions.
>
> Take a look at this:
>
> http://opioids.com/naloxone/depcrf.html
> ----------------------------
> The effect of naloxone on adrenocorticotropin and cortisol release: evidence for a reduced response in depression
> by
> Burnett FE, Scott LV, Weaver MG, Medbak SH, Dinan TG
> Department of Psychological Medicine,
> The Medical Colleges of St. Bartholomew's
> and the Royal London Hospitals,
> West Smithfield, UK.
> J Affect Disord 1999 Jun; 53(3):263-8
>
> ABSTRACT
>
> BACKGROUND: Endogenous opioid peptides inhibit the hypothalamic-pituitary-adrenal (HPA) axis by influencing the release of hypothalamic corticotropin releasing factors. This study examines whether increased activity of the HPA axis in major depression is associated with reduced opioid tone. METHODS: We measured the adrenocorticotropin (ACTH) and cortisol responses to an intravenous bolus of naloxone 0.125 microg/kg in 13 depressed outpatients and 13 healthy volunteers. RESULTS: The mean cortisol response was significantly reduced (P<0.05), and the ACTH response was also non-significantly reduced in the depressed subjects. CONCLUSIONS: These findings imply that the degree of inhibitory endogenous opioid tone is reduced in depression. Various mechanisms for the finding are discussed, including possible alteration in the function of alpha-adrenergic pathways. CLINICAL IMPLICATIONS: Reduced endogenous opioid tone may explain why some depressed individuals self-medicate with opiates, and depression is associated with opiate withdrawal. Opioid pathways may have a role in the mechanism of action of antidepressant drugs, and may be of relevance in the development of novel antidepressants. LIMITATIONS OF THE STUDY: The sample size was small, leading to a failure of the difference of the basal cortisol levels and also the delta ACTH between the groups to reach statistical significance.
>
> -----------------------
>
> Now don't misunderstand me -I'm not advocating opiate therapy as a first-line therapy by ANY means. However, one cannot generalize that all "addicitive" medications will ultimately briing out the "addicit" in all of us - no matter what. This is not true. Not all people who drink alcohol are alcoholics - correct?
>
> I believe that "fairywing's" positive antidepressant repsonse to Vicodin is an important clue that points to other models of depressive response that do NOT include the basic - overused and over-simplfied model of "serotonin-imbalance." These "other" models include imbalnces in the HPA axis/cortisol levels/hormonal balances, etc.
>
> I believe we have to accept that an imbalance in serotonin most likely is the RESULT of imblances within other neural-hormonal systems within the brain.
>
> I don't mean to negate anything you are saying - or disrepect you - or preach - I just wanted to post my experiences.
>
> Thanks
> JerryNo disrespect taken. Bottom line is that you are right. Thanks for the information and the manner in which you delivered it. I found your post to be very interesting, and I'm glad that Opiates can be used for depression and more. I know when I take Vicodin/hydrocodone it makes me feel good both physically and mentally - it puts me in a better mood. Thanks for correcting me, I don't want a bunch of bad and wrong information out
there. I wish you all the best Jerry.
Tyler
Posted by bassman on March 17, 2006, at 13:44:39
In reply to Re: Vicodin questions............ » fairywings, posted by Phillipa on March 15, 2006, at 19:56:07
Wow, people certainly do respond differently! I pinched a nerve in my back and the doc was willing to give me anything to relieve the pain. I tried both Vicodin and Percocet and both of them just made me stupid...didn't do much for the pain, didn't make me feel good emotionally, just dull. I ended up with an ice pack and yoga after one try with each med.
Posted by James K on March 17, 2006, at 15:16:19
In reply to Vicodin questions............, posted by fairywings on March 15, 2006, at 0:57:52
I've had enough surgeries in my life to have a lot of experience with vicodin. I have also had big substance abuse issues. The two never seemed to intersect in my case. I've seen though in rehab the people who became very addicted to pain pills.
For a while, when I had some, half a vicodin would get me through the last half of the last day of the work week. My aches and pains of chronic fatigue, and annoyance at the world would fade, and I could enjoy and be productive. In a perfect world, I would be allowed one a day as needed for ulcerative colitis and chronic fatigue. But in today's political climate in US at least it is sinful.
I wouldn't (my opinion only) mention "misuse" to you doctor, or he may yank it. And I've never had access to enough of it for a long enough period of time to discover if it would have become an abuse drug for me.
Oh, and the tylenol issue is very real, and my mind is blown when I'm in a rehab situation and hear how many some people take in a day. A medical disaster waiting to happen.
James K
Posted by fairywings on March 17, 2006, at 15:30:24
In reply to Re: Vicodin questions............, posted by James K on March 17, 2006, at 15:16:19
Thanks for all the replies. You all are awesome. Well I decided vicodin probably isn't the thing for me, I'm too afraid of addiction since my father was an alcoholic. But I can sure understand the use of opiods for depression when they make you feel better, I'm glad some docs consider it an option.
fairywings
Posted by LizinManhattan on March 17, 2006, at 23:33:45
In reply to Vicodin questions............, posted by fairywings on March 15, 2006, at 0:57:52
Hi,
My brother was prescribed hydrocodone for his depression and anxiety (he was all ready taking Cymbalta). It worked well for a couple of hours but then he just got agitated, confrontational and depressed. Supposedly it works for some people though. Maybe you're one of them! I posted about my brotehr and hydrocodone a while back. Here is a link to the thread: http://www.dr-bob.org/babble/20060219/msgs/613278.html
I would tell my pdoc about the misuse, but he is unusally open-minded. Maybe just tell your pdoc that the Vicodin made you feel good and that you researched it and as a result are curious about hydrocodone...
Good luck!
Liz
Posted by BIGDaddyachmed69 on March 17, 2006, at 23:47:50
In reply to Vicodin questions............, posted by fairywings on March 15, 2006, at 0:57:52
Looks like you've already gotten a fair number of responses, but I figured I'd throw my two cents in. Vicodin's power stuff, Percocet, Oxycontin, they're even stronger. Very addictive. I've heard benzo withdrawal is just about the worst, next to alcohol. But you don't wanna get hooked on this stuff, as calm and collected as they make you feel. No doc's going to prescribed Vicodin for depression or w/e, but I'm sure you already know that. Talk to your talk about trying something "non-habit forming". I don't know if I'd bring up the fact that you've been taking Vicodin for migraines. In my experience, you're automatically labeled an addict when you mention taking meds of any kind for reasons other than they were intended to be taken. Either that or escalating the dose.
> I noticed after my last couple of migraines, that if I took Vicodin I wasn't as prone to get ticked off at my kids when they're doing things that annoy me - like fighting and then carrying on excessively.
>
> So, yesterday and today I was a bit depressed, pms-ing and really irritable, but didn't have a migraine. I took Vicodin to see what it would do for me, and I was calm and not irritable at all.
>
> I've been more depressed and more irritable lately, but I'm not on an anti-depressant right now. Is there an anti-depressant that will make me less depressed and less irritable, but not sleepy or lethargic, help with the irritability, not affect my cognitive abilities, and not cause weight gain? Ah, the perfect med. right?
>
> Should I tell my pdoc what the Vicodin did for me, or would taking it when I didn't have a migraine be a no-no? I mean rationally, I know I shouldn't take it when I don't have a migraine, but does it help to know it affected my mood like that? I'd hate to lose the one thing that really helps when I have a raging migraine.
>
> Any thoughts?
> fw
Posted by fairywings on March 18, 2006, at 0:51:44
In reply to Re: Vicodin questions............ » fairywings, posted by BIGDaddyachmed69 on March 17, 2006, at 23:47:50
Thanks Liz and BD,
Sorry about your brother Liz, I hope he's found something else to help him. I've never abused Vicodin in the sense of taking too much, but I sure don't want to start a nasty habit.
fw
Posted by jerrympls on March 19, 2006, at 16:53:07
In reply to Re: Vicodin questions............ » jerrympls, posted by TylerJ on March 16, 2006, at 9:57:01
> >
> > >
> > > Great for pain, but for clinical depression it is a dead-end!
> > >
> > > Tyler
> >
> > I'll have to disagree with you Tyler. My doctor has me on hydrocodone 5mg 4x daily along with my other meds for depression. There ARE studies out there supporting the use of opiates in treatment-resistant cases. I've been on hydrocodone (the opiate part of Vicodin) for 18 months now. No tolerance. No abuse. No change in dosage. This is actually a typical response from those on opiates w/ treatment-resistant depressions.
> >
> > Take a look at this:
> >
> > http://opioids.com/naloxone/depcrf.html
> > ----------------------------
> > The effect of naloxone on adrenocorticotropin and cortisol release: evidence for a reduced response in depression
> > by
> > Burnett FE, Scott LV, Weaver MG, Medbak SH, Dinan TG
> > Department of Psychological Medicine,
> > The Medical Colleges of St. Bartholomew's
> > and the Royal London Hospitals,
> > West Smithfield, UK.
> > J Affect Disord 1999 Jun; 53(3):263-8
> >
> > ABSTRACT
> >
> > BACKGROUND: Endogenous opioid peptides inhibit the hypothalamic-pituitary-adrenal (HPA) axis by influencing the release of hypothalamic corticotropin releasing factors. This study examines whether increased activity of the HPA axis in major depression is associated with reduced opioid tone. METHODS: We measured the adrenocorticotropin (ACTH) and cortisol responses to an intravenous bolus of naloxone 0.125 microg/kg in 13 depressed outpatients and 13 healthy volunteers. RESULTS: The mean cortisol response was significantly reduced (P<0.05), and the ACTH response was also non-significantly reduced in the depressed subjects. CONCLUSIONS: These findings imply that the degree of inhibitory endogenous opioid tone is reduced in depression. Various mechanisms for the finding are discussed, including possible alteration in the function of alpha-adrenergic pathways. CLINICAL IMPLICATIONS: Reduced endogenous opioid tone may explain why some depressed individuals self-medicate with opiates, and depression is associated with opiate withdrawal. Opioid pathways may have a role in the mechanism of action of antidepressant drugs, and may be of relevance in the development of novel antidepressants. LIMITATIONS OF THE STUDY: The sample size was small, leading to a failure of the difference of the basal cortisol levels and also the delta ACTH between the groups to reach statistical significance.
> >
> > -----------------------
> >
> > Now don't misunderstand me -I'm not advocating opiate therapy as a first-line therapy by ANY means. However, one cannot generalize that all "addicitive" medications will ultimately briing out the "addicit" in all of us - no matter what. This is not true. Not all people who drink alcohol are alcoholics - correct?
> >
> > I believe that "fairywing's" positive antidepressant repsonse to Vicodin is an important clue that points to other models of depressive response that do NOT include the basic - overused and over-simplfied model of "serotonin-imbalance." These "other" models include imbalnces in the HPA axis/cortisol levels/hormonal balances, etc.
> >
> > I believe we have to accept that an imbalance in serotonin most likely is the RESULT of imblances within other neural-hormonal systems within the brain.
> >
> > I don't mean to negate anything you are saying - or disrepect you - or preach - I just wanted to post my experiences.
> >
> > Thanks
> > Jerry
>
> No disrespect taken. Bottom line is that you are right. Thanks for the information and the manner in which you delivered it. I found your post to be very interesting, and I'm glad that Opiates can be used for depression and more. I know when I take Vicodin/hydrocodone it makes me feel good both physically and mentally - it puts me in a better mood. Thanks for correcting me, I don't want a bunch of bad and wrong information out
> there. I wish you all the best Jerry.
>
>
> Tyler
>
Hey Tyler - I'm glad my post didn't come across the wrong way. I always worry that sometimes by posting scientific abstarcts, etc that it may come across as "You're WRONG and Im RIGHT!" We each have our own experiences and what may work for me may not work for someone else. Ya know.Jerry :-)
Posted by jerrympls on March 19, 2006, at 16:55:01
In reply to Re: Vicodin questions............, posted by bassman on March 17, 2006, at 13:44:39
> Wow, people certainly do respond differently! I pinched a nerve in my back and the doc was willing to give me anything to relieve the pain. I tried both Vicodin and Percocet and both of them just made me stupid...didn't do much for the pain, didn't make me feel good emotionally, just dull. I ended up with an ice pack and yoga after one try with each med.
TOO much Vicodin or oxycodone makes me "stupid" as well - I can't get words out and when I am trying to make a point I forget right in the middle of explaining it what the point was in the first place.Jerry :-)
Posted by jerrympls on March 19, 2006, at 17:05:31
In reply to Re: Vicodin questions............, posted by James K on March 17, 2006, at 15:16:19
> I've had enough surgeries in my life to have a lot of experience with vicodin. I have also had big substance abuse issues. The two never seemed to intersect in my case. I've seen though in rehab the people who became very addicted to pain pills.
>
> For a while, when I had some, half a vicodin would get me through the last half of the last day of the work week. My aches and pains of chronic fatigue, and annoyance at the world would fade, and I could enjoy and be productive. In a perfect world, I would be allowed one a day as needed for ulcerative colitis and chronic fatigue. But in today's political climate in US at least it is sinful.
>
> I wouldn't (my opinion only) mention "misuse" to you doctor, or he may yank it. And I've never had access to enough of it for a long enough period of time to discover if it would have become an abuse drug for me.
>
> Oh, and the tylenol issue is very real, and my mind is blown when I'm in a rehab situation and hear how many some people take in a day. A medical disaster waiting to happen.
>
> James KI agree with James - not to mention any "misuse." I always would bring it up to my doctor in this manner:
"In the past when I've been on VIcodin for vairous dental procedures, etc., I've always had such a positive antidepressant response - not a 'high' - just more of a feeling that th ebottom wouldn't drop out from under me and a better sense of well-being."
...which of course was/is 100% true.
Also, there's the problem of too much tylenol (acetometaphen). They say 4grams/day is the limit. This is part of the reason my doctor tried me on the Fentanyl Patch (Duragesic) and then Oxycontin (which is once-daily, extended release - no acetometaphen). However, the Fentanyl didn't do anything and the Oxycontin made me foggy and "stupid." We found a version of hydrocodone that did NOT contain any acetometaphen called HYCODAN. Which is usually a form prescribed for chronic cough. It contains 5mg hydrocodone and a sub-therapeutic level of homatropine. The blurb says that the homatropine is to lessen the chance of any overdosage. I've never looked into how it "protects" one from overdosing. However, I wish there were an extended-release form of hydrocodone. You'd think there would be with its popularity.
Jerry :-)
Posted by jerrympls on March 19, 2006, at 17:13:38
In reply to Re: Vicodin questions............ » BIGDaddyachmed69, posted by fairywings on March 18, 2006, at 0:51:44
>
>
> Thanks Liz and BD,
>
> Sorry about your brother Liz, I hope he's found something else to help him. I've never abused Vicodin in the sense of taking too much, but I sure don't want to start a nasty habit.
>
> fwINteresting how much abuse is brought up - I mean, it doesn't surprise me. What does surpise me is one study where Oxycontin was successfully used to help treat treatment-resistnat depression in 4 people - 3 of whom had been addicts.
Here's some more info I have gathered - just FYI:
----------------
8: Biomed Pharmacother. 1996;50(6-7):279-82.
Treatment of depressive syndromes in detoxified drug addicts: use of
methadone.Laqueille X, Bayle FJ, Spadone C, Jalfre V, Loo H.
Service Hospitalo-Universitaire de Sante Mentale et de Therapeutique,
Centre
Hospitalier Specialise Sainte-Anne, Paris, France.Depressive syndromes are very frequent in drug-addicted patients. Their
study is particularly difficult on account of the toxic intake which disturbs
the clinical analysis. Methadone has improved our understanding of these
pathologies. In fact, methadone permits treatment of some depressive
disorders typically linked to addiction, such as a motivational symptoms and
depressive mood following intoxication. It brings to the fore the other mood
disorders which are often associated with drug intake.Publication Types:
Review
Review, TutorialPMID: 8952868 [PubMed - indexed for MEDLINE]
--------------
9: J 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.Publication Types:
Case Reports
Clinical TrialPMID: 7714228 [PubMed - indexed for MEDLINE]
-------------------------
10: J Subst Abuse Treat. 1990;7(1):51-4.
Depressive symptoms during buprenorphine treatment of opioid abusers.
Kosten TR, Morgan C, Kosten TA.
Department of Psychiatry, Yale University School of Medicine, New Haven,
CT.Among 40 opioid addicts treated as outpatients with sublingual
buprenorphine (2-8 mg daily) for a month, depressive symptoms significantly decreased in the 19 who were depressed at intake to treatment.PMID: 2313769 [PubMed - indexed for MEDLINE]
-----------------------
11: Int Clin Psychopharmacol. 1988 Jul;3(3):255-66.
Current and historical concepts of opiate treatment in psychiatric
disorders.Weber MM, Emrich HM.
Max-Planck-Institut fur Psychiatrie, Munchen, Federal Republic of
Germany.In recent years psychiatric research has rediscovered the theoretical
and clinical importance of opiates, especially for the understanding of
depressive disorders. However, opiate treatment is not a new therapeutic concept
in psychiatry. The use of opium for "melancholia" and "mania" may be traced to ancient classical medicine. After Paracelsus and Sydenham, the psychiatry of the German Romantic Era widely discussed therapeutic opium use with the Engelken family going on to develop a structured opium treatment of depression in the first half of the nineteenth century. Although the underlying scientific problems of psychiatric opium therapy were never solved, it gained an outstanding position as a practical treatment for over 100 years.Publication Types:
Historical ArticlePMID: 3153713 [PubMed - indexed for MEDLINE]
-----------------------1: Psychoneuroendocrinology. 1988;13(5):397-408.
Human studies on the mu opiate receptor agonist fentanyl: neuroendocrine and behavioral responses.
Hoehe M, Duka T, Doenicke A.
Psychiatric Hospital, University of Munich, F.R.G.
The neuroendocrine and behavioral responses to the potent mu opiate receptor agonist Fentanyl (FE) have been systematically investigated in healthy male volunteers. These volunteers received, according to a randomized block design, different doses of FE: 0.1 mg/70 kg (n = 11), 0.2 mg/70 kg (n = 11), 0.25 mg/70 kg (n = 8), and saline (n = 11). FE induced a pronounced dose-dependent increase of plasma prolactin concentrations, which was significant at the lowest dose. In contrast, growth hormone was significantly stimulated by the highest FE dose only. Moreover, FE induced a maximum reduction of plasma cortisol concentrations at the lowest dose (0.1 mg/70 kg). In parallel, marked euphoric responses were also observed at this lowest FE dose. These results suggest a mu specific influence on all neuroendocrine and behavioral parameters investigated. Different responses of these parameters to different doses of FE, however, suggest a differential modulation of these parameters by the mu receptor agonist FE.
Publication Types:
• Clinical Trial
• Randomized Controlled TrialPMID: 2849775 [PubMed - indexed for MEDLINE]
------------------------------------------------------------------------------
1: J Clin Psychiatry. 2001 Mar;62(3):205-6.Treatment of refractory major depression with tramadol monotherapy.
Shapira NA, Verduin ML, DeGraw JD.
Publication Types:
• Case Reports
• LetterPMID: 11305709 [PubMed - indexed for MEDLINE]
------------------------------------------------------------------------------
1: Am J Psychiatry. 1999 Dec;156(12):2017.
Treatment augmentation with opiates in severe and refractory major depression.Stoll AL, Rueter S.
Publication Types:
• Case Reports
• LetterPMID: 10588427 [PubMed - indexed for MEDLINE]
------------------------------------------------------------------------------
Prog Neuropsychopharmacol Biol Psychiatry. 2001 Feb;25(2):457-62.
Dose-dependent augmentation effect of bromocriptine in a case with refractory depression.Wada T, Kanno M, Aoshima T, Otani K.
Department of Neuropsychiatry, Yamagata University School of Medicine, Japan.
1. A 52-year-old female with refractory depression had not responded to various treatments including electroconvulsive therapy and augmentation therapy with lithium or triiodothyronine. 2. Addition of bromocriptine 2.5-5 mg/day to imipramine improved her depressive symptoms. However, when the dose was increased to 15 mg/day to treat residual depressive symptoms, her clinical status deteriorated and returned to the original level. The dose reduction to 5mg/day again improved her depressive symptoms. 3. This report confirms the augmentation effect of bromocriptine for refractory depression. It also suggests that there is dose-dependency in this effect.
Publication Types:
• Case ReportsPMID: 11294489 [PubMed - indexed for MEDLINE]
----------------------------------------------------------------------------------------------
1: Adv Biochem Psychopharmacol. 1982;32:77-84.
A possible role of opioid substances in depression.
Emrich HM.
Publication Types:
• ReviewPMID: 7046369 [PubMed - indexed for MEDLINE]
------------------------------------------------------------------------------
Posted by fairywings on March 19, 2006, at 18:29:39
In reply to Re: Vicodin questions............ » TylerJ, posted by jerrympls on March 19, 2006, at 16:53:07
Hey Jerry,
I don't think your post came across that way at all. I took it more like - there might very well be another way to look at this, or there might be some indications for the use of opiates for depression. You've been very polite and thoughtful. ; )
thanks,
fw
Posted by jerrympls on March 19, 2006, at 18:48:26
In reply to Re: Vicodin questions............ » jerrympls, posted by fairywings on March 19, 2006, at 18:29:39
>
>
> Hey Jerry,
>
> I don't think your post came across that way at all. I took it more like - there might very well be another way to look at this, or there might be some indications for the use of opiates for depression. You've been very polite and thoughtful. ; )
>
> thanks,
> fwgreat!! I'm glad. I hoep things work out for you!
Jerry :-)
This is the end of the thread.
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