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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 5 to 29 of 39. Go back in thread:
Posted by Wolf Dreamer on November 28, 2006, at 20:49:36
In reply to Re: Racing thoughts, fear of bullying, etc. what m, posted by fenix on November 28, 2006, at 18:25:40
> Opiates. This is my default answer to anything anxiety and depression related. If I ever find anything more effective than an opiate I will start using that as my answer.
When I google "opiates" it just list various illegal drugs. Are you refering to opium, heroin, and morphine?
Posted by notfred on November 28, 2006, at 21:06:23
In reply to legal? » fenix, posted by Wolf Dreamer on November 28, 2006, at 20:49:36
> When I google "opiates" it just list various
> illegal drugs. Are you refering to opium, heroin, > and morphine?
Those are all legal, or at least they can be.
Opium is in pargorics. Heroin under the name diamorphine, is a legal prescription drug in the United Kingdom & morphine is a common pain med.
Posted by Quintal on November 28, 2006, at 21:43:51
In reply to Racing thoughts, fear of bullying, etc. what meds?, posted by Wolf Dreamer on November 28, 2006, at 15:17:59
I think fenix may be referring to buprenorphine, which is a synthetic opiate normally used to help detox herion addicts. Some people on this board have managed to get prescriptions of bupe from their pdocs for anxiety and depression. Kratom is a herb that has opiate and cocaine-like effects. I've tried it myself and the results are very nice. Not sure about availablilty in the US though.
Beta blockers do not help so much with feelings of anxiety, more with the physical symptoms of sweating and shaking etc. Some beta blockers made me feel more anxious. I think pindolol is particularly recommeded where a person is at risk of developing depression.
I imagine benzos would be very effective for the problems you describe, though SSRIs like Lexapro and Paxil are more widely acceptable first line treatments.
Good luck.
Q
Posted by zmg on November 29, 2006, at 15:42:28
In reply to Re: Racing thoughts, fear of bullying, etc. what meds? » Wolf Dreamer, posted by Quintal on November 28, 2006, at 21:43:51
Kratom is available in the US but its legal status is at best dubious (because of our analogue law):
"The Federal Analogue Act defines an analog as a substance which is 'substantially similar' to a scheduled substance and has either an effect 'similar to or greater than' a controlled substance or is thought to have such an effect. The law fails to define what 'substantially similar' means, nor does it try to clarify what would constitute a 'similar or greater' effect."
http://www.erowid.org/psychoactives/law/analog/analog_info1.shtml
Posted by linkadge on November 29, 2006, at 17:04:20
In reply to Re: Racing thoughts, fear of bullying, etc. what m » Quintal, posted by zmg on November 29, 2006, at 15:42:28
>I'm terrorfied about being caught out in a >situation where I'm helpless, unable to stop >someone from speaking to me, pressuring me for >something, staring me down, touching me, or >standing close to me for the purpose of >intimidation.
Does this happen often? Not that drugs can't help, but if you are being bullied I wouldn't take drugs to forget about it, I would speak to somebody who can help you.
If this is happening to you, it should't be, and you shouldn't be forced to live in fear because of it happening.
I know easier said than done, but its the truth.
Linkadge
Posted by Quintal on November 29, 2006, at 17:10:22
In reply to Re: Racing thoughts, fear of bullying, etc. what m » Quintal, posted by zmg on November 29, 2006, at 15:42:28
It's always risky to introduce a new drug in the US. I know here in the UK most head shops refuse to export their legal cannabis substitutes etc. to the US in fear of them being prohibited and the UK legislators following suit.
Q
Posted by zmg on November 29, 2006, at 17:22:18
In reply to Re: Racing thoughts, fear of bullying, etc. what m » zmg, posted by Quintal on November 29, 2006, at 17:10:22
The US (probably the world) is strange. I was just in Los Angeles last weekend and the weekly had ads all over it for medical marihuana, including free samples.
Made me laugh (not that I think treatment is funny, but our drug policy is so crazy).
Posted by Quintal on November 29, 2006, at 17:56:02
In reply to Re: Racing thoughts, fear of bullying, etc. what m, posted by zmg on November 29, 2006, at 17:22:18
Hmmmm. What next? We're already seeing people on this board being prescribed opiates for depression and anxiety. I am aware of people advocating the use of coca leaves and coca leaf tea to treat the same conditions. Even crack cocaine has been used successfully to treat arthritis without abuse problems (in the elderly sample community that was studied)!
Q
Posted by notfred on November 29, 2006, at 18:39:18
In reply to Re: Racing thoughts, fear of bullying, etc. what m » zmg, posted by Quintal on November 29, 2006, at 17:56:02
> Hmmmm. What next?
It is not the drug that is the problem it is what people do with them that is the problem.Cocaine is used in some plastic surgery procedures.
My plastic surgeon said it is prefered as a numbing agent from some procedures.
Posted by Quintal on November 29, 2006, at 18:49:47
In reply to Re: Racing thoughts, fear of bullying, etc. what m, posted by notfred on November 29, 2006, at 18:39:18
I agree, and I'm all for it.
Q
Posted by Crazy Horse on November 29, 2006, at 19:13:14
In reply to Re: Racing thoughts, fear of bullying, etc. what m, posted by linkadge on November 29, 2006, at 17:04:20
> >I'm terrorfied about being caught out in a >situation where I'm helpless, unable to stop >someone from speaking to me, pressuring me for >something, staring me down, touching me, or >standing close to me for the purpose of >intimidation.
>
> Does this happen often? Not that drugs can't help, but if you are being bullied I wouldn't take drugs to forget about it, I would speak to somebody who can help you.
>
> If this is happening to you, it should't be, and you shouldn't be forced to live in fear because of it happening.
>
> I know easier said than done, but its the truth.
>
> Linkadge
>
>
>
Personally i think you have OCD and social anxiety disorder. I think you would benefit from medication,i.e. an antidepressant..probably start out w/an ssri like Paxil, and then possibly an snri, tca, and last but not least an MAOI. If your anxiety is very high i think adding a benzodiazapine like Klonopin would be of help. I would highly recommend counseling along with the medication.Of course this is only my personal opinion, and i am not a Doctor. The first thing i would recommend is a Board Certified Psychiatrist.
Good Luck.
-MJ
Posted by zmg on November 29, 2006, at 20:48:39
In reply to Re: Racing thoughts, fear of bullying, etc. what m » zmg, posted by Quintal on November 29, 2006, at 17:56:02
Honestly I always liked the idea of the opiates. Depression does cause pain that they can seem to ease (but I don't think addiction is a good trade-off).
I was hoping for more from the agonist-antagonist compounds, but at least its got us thinking more in that direction (I've seen recent ads on TV talking about pain in regards to depression).
Doesn't tramadol have mixed opiod/serotonergic effect?
Cracks long-term effect probably out-weigh any short-term effects (although its said that drug abuse is self-medication).
Posted by Quintal on November 29, 2006, at 22:11:21
In reply to Re: Racing thoughts, fear of bullying, etc. what m » Quintal, posted by zmg on November 29, 2006, at 20:48:39
Tramadol has some opioid and SSNRI effects, so making it a bit like Effexor and codeine combined in a single drug.
The crack that was used in the study I saw was ground into fine crystals and 'insufflated' by the volunteers. The idea was that the crack crystals would dissolve slowly in the nasal passages - Crack XR of sorts, and it worked. They called their crack preparation Esterene. It was not approved because according to the advisory panel on internal medicine and orthopaedics there is no scientific evidence to support it. <Sigh> http://www.pubmedcentral.nih.gov/pagerender.fcgi?artid=1273578&pageindex=1
I think you're right about the mixed agonist-antagonist drugs being the way forward. This is discussed at length in the 'Intoxication' book.
Q
Posted by Wolf Dreamer on November 30, 2006, at 8:24:50
In reply to Re: Racing thoughts, fear of bullying, etc. what m, posted by linkadge on November 29, 2006, at 17:04:20
> >I'm terrorfied about being caught out in a >situation where I'm helpless, unable to stop >someone from speaking to me, pressuring me for >something, staring me down, touching me, or >standing close to me for the purpose of >intimidation.
>
> Does this happen often? Not that drugs can't help, but if you are being bullied I wouldn't take drugs to forget about it, I would speak to somebody who can help you.
>
> If this is happening to you, it should't be, and you shouldn't be forced to live in fear because of it happening.
>
> I know easier said than done, but its the truth.
>
> Linkadge
>I haven't had any problems with bullies since back in school. However, once conditioned, the amygdala never lets up.
I don't live in a safe area though, and I know there are a lot of aggressive, impulsive, and violent people around here, which troubles me greatly.
Anyway, I went to the doctor yesterday, and was prescribed Propranolol and Celexa. They are both generic, and WalMart sells a 30 day supply for $2 for one of them and $4 for the other! Amazing how cheap it is. I started taking them this morning.
Posted by Wolf Dreamer on November 30, 2006, at 8:30:49
In reply to Re: Racing thoughts, fear of bullying, etc. what m, posted by Crazy Horse on November 29, 2006, at 19:13:14
> Of course this is only my personal opinion, and i am not a Doctor. The first thing i would recommend is a Board Certified Psychiatrist.
>
> Good Luck.
>
> -MJ
>
If the Cerified Psychiatrist is bored, doesn't that make them dangerous? ;) Sorry, lame joke.My doctor seemed rather bored, and peeved I had printed out information to show him, asking for a certain drug. I got it though, and that is all that mattered.
Posted by Quintal on November 30, 2006, at 8:53:37
In reply to Bored Board doctors are dangerous, + termites » Crazy Horse, posted by Wolf Dreamer on November 30, 2006, at 8:30:49
>My doctor seemed rather bored, and peeved I had printed out information to show him, asking for a certain drug. I got it though, and that is all that mattered.
I started a discussion on the topic of pdoc persuasion tactics a while ago. You may find it useful for future drug requests? http://www.dr-bob.org/babble/20061110/msgs/704183.htmlQ
Posted by zmg on November 30, 2006, at 11:45:51
In reply to Re: Racing thoughts, fear of bullying, etc. what m » zmg, posted by Quintal on November 29, 2006, at 22:11:21
This book sounds too interesting! I've ordered it today!
Can't wait for it to come!
Posted by notfred on November 30, 2006, at 21:29:27
In reply to Re: Racing thoughts, fear of bullying, etc. what m » notfred, posted by Quintal on November 29, 2006, at 18:49:47
> I agree, and I'm all for it.
>
> Q
Cocaine was no fun when it is was used as a numbing agent during numerious surgeries to put my face back together after a bad car crash a decade ago.
Posted by Quintal on November 30, 2006, at 22:41:12
In reply to Re: Racing thoughts, fear of bullying, etc. what m, posted by notfred on November 30, 2006, at 21:29:27
>Cocaine was no fun when it is was used as a numbing agent during numerious surgeries to put my face back together after a bad car crash a decade ago.
I wouldn't expect it to be fun given the set and setting. Much like having unlimited access morphine isn't much fun to the terminally ill cancer patient.
I think doctors usually use epinephrine as a vasoconstrictor to limit the spread of cocaine into the bloodstream during these procedures, so that would likely put the dampeners on any potential high.
Q
Posted by notfred on November 30, 2006, at 22:55:41
In reply to Re: Racing thoughts, fear of bullying, etc. what m » notfred, posted by Quintal on November 30, 2006, at 22:41:12
>
> I think doctors usually use epinephrine as a vasoconstrictor to limit the spread of cocaine into the bloodstream during these procedures, so that would likely put the dampeners on any potential high.
>
> QCocaine itself is a vasoconstrictor.
Posted by Quintal on November 30, 2006, at 23:18:53
In reply to Re: Racing thoughts, fear of bullying, etc. what m, posted by notfred on November 30, 2006, at 21:29:27
http://en.wikipedia.org/wiki/Cocaine
"Cocaine as a local anesthetic.
Cocaine was historically useful as a topical anesthetic in eye and nasal surgery, although it is now predominantly used for nasal and lacrimal duct surgery. The major disadvantages of this use are cocaine's intense vasoconstrictor activity and potential for cardiovascular toxicity. Cocaine has since been largely replaced in Western medicine by synthetic local anaesthetics such as benzocaine, proparacaine, and tetracaine though it remains available for use if specified.
***If vasoconstriction is desired for a procedure (as it reduces bleeding), the anesthetic is combined with a vasoconstrictor such as phenylephrine or epinephrine.*** In Australia it is currently prescribed for use as a local anesthetic for conditions such as mouth and lung ulcers. Some Australian ENT specialists occasionally use cocaine within the practice when performing procedures such as nasal cauterization. In this scenario dissolved cocaine is soaked into a ball of cotton wool, which is placed in the nostril for the 10-15 minutes immediately prior to the procedure, thus performing the dual role of both numbing the area to be cauterized and also vasoconstriction.">Cocaine was no fun when it is was used as a numbing agent during numerious surgeries to put my face back together after a bad car crash a decade ago.
It wasn't much fun for me in recreational setting either. 120mg Parnate gave me a stronger hit. Overrated in my view.
Was this when your depression started?
Q
Posted by notfred on November 30, 2006, at 23:46:40
In reply to Re: Racing thoughts, fear of bullying, etc. what m » notfred, posted by Quintal on November 30, 2006, at 23:18:53
> http://en.wikipedia.org/wiki/Cocaine
> The major disadvantages of this use are >cocaine's >intense vasoconstrictor activity and
It is a vasoconstrictor all by itself, and quite a powerful one. Illicit intranasal use has this limiting factor. The vasoconstrictor effects of cocaine itself or with an added agent are to control bleeding, not to limit the "high" from it.
Otherwise no one would ever "snort" coke.
The accident was ~10 yrs ago, my depression predates this by over a decade. Mood disorder is/can be a comorbidity with learning disabilities. I am dyspraxic.
Posted by notfred on November 30, 2006, at 23:52:26
In reply to Re: Racing thoughts, fear of bullying, etc. what m » notfred, posted by Quintal on November 30, 2006, at 23:18:53
"Cocaine has since been largely replaced in Western medicine by synthetic local anaesthetics such as benzocaine, proparacaine, and tetracaine though it remains available for use if specified. If vasoconstriction is desired for a procedure (as it reduces bleeding), the anesthetic is combined with a vasoconstrictor such as phenylephrine or epinephrine."
Looks to me like they are saying you have to add a
vasoconstrictor to synthetic local anaesthetics, but not cocaine, given it is a powerful vasoconstrictor.
Posted by Quintal on December 1, 2006, at 9:54:14
In reply to Re: Racing thoughts, fear of bullying, etc. what m, posted by notfred on November 30, 2006, at 23:46:40
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7991261&dopt=Abstract
--------------------------------------------------
Vasoconstrictive effects of cocaine and lidocaine with epinephrine in the hamster cheek pouch model.Raster JF, Chow JM.
Department of Otolaryngology-Head and Neck Surgery, Loyola University Medical Center, Maywood, IL 60153.
Otolaryngologists frequently use cocaine and lidocaine with epinephrine for their anesthetic and vasoconstrictive effects. However, no studies have visually compared the vasoconstrictive effects of cocaine to lidocaine with epinephrine. This study used the everted hamster cheek pouch model to assess the vasoconstrictive effects of cocaine and lidocaine with epinephrine by measuring the diameter changes of arterioles. Our results showed that locally injected 1% lidocaine with 1:100,000 units epinephrine caused the greatest diameter reduction in arterioles to 32% of the initial resting diameter. Topical 1% lidocaine with 1:100,000 units epinephrine caused a gradual reduction in diameter with findings equivalent to those of injected 1% lidocaine with 1:100,000 units epinephrine at 30 minutes. ***Topical 5% cocaine HCl showed a minimal response, with a reduction to only 85% of the resting arteriolar diameter.*** Topical NaCl and injected NaCl controls showed no significant arteriolar reduction. Vasoconstrictive differences between the preparations were statistically significant (p < 0.05). ***Five percent cocaine is a much weaker vasoconstrictor than locally injected 1% lidocaine with 1:100,000 units epinephrine.***
PMID: 7991261 [PubMed - indexed for MEDLINE]
-------------------------------------------------->It is a vasoconstrictor all by itself, and quite a powerful one. Illicit intranasal use has this limiting factor. The vasoconstrictor effects of cocaine itself or with an added agent are to control bleeding, not to limit the "high" from it.
Otherwise no one would ever "snort" coke.Well you are saying on one hand that cocaine is a powerful vasoconstrictor, enough so to limit absorption when taken intransally, yet I know enough cocaine can still be absorbed via this route to render the cocaine abuser dangerously intoxicated.
I read, I think in the book "Intoxication" that where cocaine is used as a local anesthetic epinephrine must also be used as a vasoconstrictor to limit systemic toxic effects (for 'toxic' read 'euphoric'). Ostensibly this use is promoted as being necessary to reduce bleeding as cocaine is too weak a vasoconstrictor to do this reliably when used alone. I haven't checked to see if this is actually used in clinical practice, but the book is an excellent source of information on all things pharmacological.
Do you know for sure the plastic surgeon did not add epinephrine to the cocaine mix?
I went to school with a pair of identical twins who were dyspraxic. I think I can understand why mood disorders are common in people who have this condition.
Q
Posted by notfred on December 1, 2006, at 14:36:26
In reply to Re: Racing thoughts, fear of bullying, etc. what m » notfred, posted by Quintal on December 1, 2006, at 9:54:14
>
> Well you are saying on one hand that cocaine is a powerful vasoconstrictor, enough so to limit absorption when taken intransally, yet I know enough cocaine can still be absorbed via this route to render the cocaine abuser dangerously intoxicated.
Yes, but with each application of coke the nose becomes less and less able to absorb. The people who die from cocaine are not usually snorters,
they are shooters or basers.
>
> Do you know for sure the plastic surgeon did not add epinephrine to the cocaine mix?
>
Yes, he wetted a cotton ball with only cocaine (pink)and placed it into my nose.
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