![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 15 to 39 of 56. Go back in thread:
Posted by Crotale on June 20, 2008, at 0:30:55
In reply to Re: Does anyone have the original buprenorphine study?, posted by undopaminergic on May 29, 2008, at 22:43:56
I've been taking Buprenex for depression since around 1998 (before it was approved for maintenance treatment of addiction in the US, where I live). At times I've had trouble getting a doctor to prescribe it since 2000. I won't say there is any *good* reason for this, but there's some presumption in the medical community that if it's used for maintenance treatment of addiction, then it must be addictive itself. In fact I haven't had issues with substance abuse the entire time I've been on buprenorphine.
Also, there has been some misinterpretation of the 2000 law that permits the use of Subutex and Suboxone for maintenance treatment of opioid dependence (the Drug Addiction Treatment Act of 2000 [DATA]). This law has *nothing* to do with the off-label use of buprenorphine to treat depression. It doesn't say that a psychiatrist has to have a waiver to prescribe buprenorphine for depression, *only* for addiction. The off-label use of buprenorphine for depression is perfectly legal. It does not require a waiver, nor should you see an addiction specialist or go to a methadone clinic or somesuch to get your depression treated. It is also perfectly legal to prescribe buprenorphine for pain. Indeed that is the approved use of Buprenex.
Here's a link to the site that explains the DATA:
http://buprenorphine.samhsa.gov/index.htmlCrotale
Posted by Crotale on June 20, 2008, at 0:49:31
In reply to Re: Does anyone have the original buprenorphine st, posted by bulldog2 on June 3, 2008, at 14:50:28
> I'm not sure who it was on babble but he tried Buprenorphine and said it pooped out after about four weeks. So there might be tolerance issues involved.
I've been taking it for around 10 years and it still works.
One of the problematic side fx is dry mouth, which can lead to dental problems. My dentist says he has encountered this in other patients on medications that have dry mouth as a side effect.
BTW, since I've had ECT, I've been able to cut back on the BUP. As a result, my last visit to the dentist had a better outcome than other recent visits.
Crotale
Posted by undopaminergic on June 20, 2008, at 17:42:23
In reply to Re: Does anyone have the original buprenorphine st, posted by Crotale on June 20, 2008, at 0:49:31
> > I'm not sure who it was on babble but he tried Buprenorphine and said it pooped out after about four weeks. So there might be tolerance issues involved.
>
> I've been taking it for around 10 years and it still works.
>
> One of the problematic side fx is dry mouth, which can lead to dental problems.
>I take BUP and other medications that contribute to the dryness of the mouth problem, so I've been trying out nicotine chewing gum recently. It seems to work, but I don't know yet if it works better than regular chewing gum (without nicotine).
Posted by Crotale on June 20, 2008, at 18:30:11
In reply to Re: Does anyone have the original buprenorphine st, posted by undopaminergic on June 20, 2008, at 17:42:23
> I take BUP and other medications that contribute to the dryness of the mouth problem, so I've been trying out nicotine chewing gum recently. It seems to work, but I don't know yet if it works better than regular chewing gum (without nicotine).
I'm not positive, but I don't think it would. The other type of cholinergic receptor (muscarinic) is the one that stimulates the salivary glands (the one that's blocked by TCAs like amitriptyline).
I chew regular sugar free gum. My dentist says to look for the type that has xylitol (e.g., Tylenol) rather than other artificial sweeteners because it's better for your teeth.
Posted by yxibow on June 23, 2008, at 2:10:16
In reply to Re: Does anyone have the original buprenorphine st » undopaminergic, posted by Crotale on June 20, 2008, at 18:30:11
> > I take BUP and other medications that contribute to the dryness of the mouth problem, so I've been trying out nicotine chewing gum recently. It seems to work, but I don't know yet if it works better than regular chewing gum (without nicotine).
>
> I'm not positive, but I don't think it would. The other type of cholinergic receptor (muscarinic) is the one that stimulates the salivary glands (the one that's blocked by TCAs like amitriptyline).
>
> I chew regular sugar free gum. My dentist says to look for the type that has xylitol (e.g., Tylenol) rather than other artificial sweeteners because it's better for your teeth.
n.b. xylitol is NOT Tylenol.
Not that people would mistake a possibly dangerous acetaminophen pill for a sugar alcohol I hope.Others would be mannitol, sorbitol, erythritol, maltitol, and lactitol.
They have a laxative effect if used more than sparingly.
Posted by Neal on September 13, 2008, at 1:47:12
In reply to Re: Does anyone have the original buprenorphine st » Crotale, posted by yxibow on June 23, 2008, at 2:10:16
I have taken Suboxone 8mgs/day for the last 2 years for unipolar depression. Opioids were just about the only things in a doctor's kit for "melancholia" from 10,000BCE until about 1950, so I thought I'd give it a try, Bush drug hysteria notwithstanding.
I found that it worked quite well when taken with other ADs. It helps with sleep, chronic pain, and anxiety espessially.
The main reason it's legal is that there's no "rush" from injecting and it's of course only a partial agonist. So it's used primarily for drug addiction.
I think there's a population of depressed people who could be helped by this drug, but the general drug hysteria generated in this country makes it hard for doctors to provide it for depression if they feel they're laying their license on the line.
Some people on this board are claiming that they got their docs to write scripts, but I found it hard, at least two years ago. Maybe things are changing for the better.
Posted by Quintal on September 13, 2008, at 11:11:18
In reply to Re: Does anyone have the original buprenorphine st, posted by Neal on September 13, 2008, at 1:47:12
I asked my pdoc for Suboxone last month and he wasn't sure at all, so he asked his collegues for advice. Both the professor and the addiction specialist he wrote to said there is no scientific evidence that opiates are of any benefit in mood disorders, except for the very limited studies I brought in from PubMed. They're right about the lack of evidence, but as you say, it has been known since the dawn of time that opaites are effective antidepressants.
Q
Posted by okydoky on September 13, 2008, at 23:11:41
In reply to Re: Does anyone have the original buprenorphine st » Neal, posted by Quintal on September 13, 2008, at 11:11:18
I spoke with my doctor two days ago. He said he just did not know how to prescribe it but had no problem besides that. I spoke with the manufacturer who said if he called they would inform him as to dose and anything else he wanted as it pertains to pain. I emailed him all the from my insurence and teh phone number of teh manufacturer in hopes when I show up on Monday he will write a script.
Does anyone know it Suboxone is nessisarily better for depression than other opiates? My insurence only covers 270mg over a "rolling" 75 days so if he does prescribe it we will have to write them so he can write for more. I take 60mg oxycontin for pain now. The manufacturer said the average dose is between 4 and 24mg a day??? The equivelent dose I found was 4.8mg a day but I know it is not always the same.
Well high to all. My computer is working again. Not sure if that is a good thing:-)
oky
Posted by Quintal on September 14, 2008, at 9:03:50
In reply to Re: Does anyone have the original buprenorphine st, posted by okydoky on September 13, 2008, at 23:11:41
That's great news oky, let me know how it goes. People have said that bupe is better for depression because it blocks kappa receptors, which can lower mood apparently.
Q
Posted by okydoky on September 14, 2008, at 12:54:43
In reply to Re: Does anyone have the original buprenorphine st » okydoky, posted by Quintal on September 14, 2008, at 9:03:50
Cross your fingers for me that he makes the call to Reckitt Benckiser and they provide th prescribing information to him. Seems he is being lazy these days. What I found was 4.8mg equivalent to 60mg oxycontin a day but how would I take it? Rhetorical:-)
Thanks
oky
Posted by okydoky on September 19, 2008, at 15:32:41
In reply to Re: Does anyone have the original buprenorphine st, posted by okydoky on September 14, 2008, at 12:54:43
My doc prescribed the Suboxone for me but just told me to take it how I was supposed to and figure out how much I need. First day I went into a little withdrawal second too. Seems okay now but it is not as good for pain. I've been pretty messed up. I still had to take Lyrica with it so the pain is taken care of but my depression is worsened. Start some instill for my bladder today hoping that will take care of this flare and i can stop the Lyrica. I just cannot know how much Suboxone I need without the Lyrica. He will need to write the insurance company because they only cover 3.6mg a day. Makes no sense to me. Oh well I think I will try to go to sleep now and escape once again. Wish I had more positive news :-0
oky
Posted by Quintal on September 19, 2008, at 16:19:48
In reply to Re: Does anyone have the original buprenorphine st, posted by okydoky on September 19, 2008, at 15:32:41
I'm sorry this isn't working for you oky. I suppose you can't take another opiate for flareups when you're on Suboxone. Do you think you'll need to go back to your old pain meds? Keep us updated. Sleep well.
Q
Posted by okydoky on September 20, 2008, at 14:30:45
In reply to Re: Does anyone have the original buprenorphine st » okydoky, posted by Quintal on September 19, 2008, at 16:19:48
No I cannot take another opiate while I am on Suboxone. I did have breakthrough pain the past two days so I just took 1mg around 8 hours after my first dose each day so far.. I am supposed to be doing physical therapy but yesterday I received a letter from the insurance denying payment. I had the wrong doc send the script so maybe I can fix this easily. I wanted to start that and daily instills and what is called DMSO instills weekly with the Suboxone giving it the best chance to work and getting out of this flare up The Suboxone does not dissolve very well, it takes around 45 minutes. I remember when I took Fentora this way it dissolved in a few minutes. Does anyone else have this problem? If I swallow it my understanding is the amount I swallow will not be available in my body as a medicine. My mind is in such a fog from the Lyrica.. Just wriring this email is a huge effort. I am trying to make sense, please give me some leeway :-)
I need to take the Suboxone when I am not in a flare to evaluate its efficacy and its efficacy with Amineptine or Parnate.
My plan was to take Suboxone with one of these antidepressants to see if one worked with it instead of with a full agonist as my pain med. As the Suboxone does not work completely I have added Naproxen. When I took 4mg the first day it suppressed my breathing too much. Ill have to work with it. This would be okay if the antidepressant works with it. Lots of variables right now. Like I cannot take the Naproxen long term as it irritates my stomach. Its only been three days so I need to be patient.
I have noticed that I feel more raw on the Suboxone as opposed to Oxycontin or Morphine.Im just blabbering on and on now.
Thanks all for the support. This is difficult. I have been having suicidal ideation for a few months now. I was hoping trying this would give me hope. Oh well. Patience!
oky
Posted by Quintal on September 20, 2008, at 16:22:06
In reply to Re: Does anyone have the original buprenorphine st, posted by okydoky on September 20, 2008, at 14:30:45
>I have noticed that I feel more raw on the Suboxone as opposed to Oxycontin or Morphine.
This isn't good. I wonder if you're still feeling some sort of withdrawal effects? I switched from codeine to tramadol last week and I had a similar feeling. Tramadol just wasn't hitting 'the place'. I've had the same problem when switching between other drugs of the same class. It should get better in a few weeks if bupe is going to work for you. It may be that morphine and oxy are better painkillers and antidepressants than bupe. Are you able to go back to the ones that work if this trial doesn't work out?
>I need to take the Suboxone when I am not in a flare to evaluate its efficacy and its efficacy with Amineptine or Parnate.
I you can get this flare under control soon. The instills sound very painful.. I don't know how you manage it. Do you have a supply of amineptine? It's something I've always wanted to try. Hopefully the ADs will help with pain control.
>The Suboxone does not dissolve very well, it takes around 45 minutes. I remember when I took Fentora this way it dissolved in a few minutes. Does anyone else have this problem? If I swallow it my understanding is the amount I swallow will not be available in my body as a medicine.
Is it like a wafer or a tablet? There was someone who used to take it up her nose, but I think she was using a lquid form. I don't know whether that's still available, but I think there's a patch that might make things easier. I know it would be too much trouble with the insurance company to switch perparation though. I don't think bupe is absorbed very well from the stomach so what you swallow won't have much effect. You can't go for 45 minutes without accidentally swallowing some, so I wonder if this might be reducing the dose you actually absorb? Is there anything you can do to the tablet to make it dissolve quicker such as crushing or grinding it (I don't know whether that is a good idea, just adding suggestions).
People here are always willing to give their support but you need RL backup for when you have these suicidal thoughts. Is there a T or a pdoc you can contact when you're feeling like this? It sounds as though your depression isn't being well managed at the moment. Are you getting continuity of care from all your doctrs? You seem to have more than one and I wonder if they communicate properly. How soon can you start the ADs, and which one will you choose?
Take care
Q
Posted by okydoky on September 20, 2008, at 23:20:23
In reply to Re: Does anyone have the original buprenorphine st » okydoky, posted by Quintal on September 20, 2008, at 16:22:06
You're very nice. I don't have a therapist. I have a urologist who is being very helpful although he makes me do all the research Hell switch me back if it does not work no problem. . I cannot take most antidepressants because they case flares. The instills dont hurt at all. They generally give me relief. The idea is to get enough relief from them as so not to have to take so much pain meds and not to have this frequency problem I use the Lyrica for. Tramadol never did much for me for pain or mentally. What are you taking pain meds for?
I have some Amineptine left to try. Maybe a week or more. Not sure about crushing the tablet. I could ask him to prescribe it as injection. Ive never done that before and I am not sure he would prescribe it.
I did not want to start the ADs until this flare was over. The Lyrica causes so much depression it would be impossible to tell if the AD was working.Years ago DMSO instills used to put me into remission. Not any more. I did not start them again until next week. I wanted to try the daily ones and they cannot have DMSO. No doubt this is too much information
I see a new pcp next week but he prescribed methadone and I did not take it so I am not sure if he still will treat me. I was going to ask him for the Parnate rx but I think it is too soon. Anyway I want to try Amineptine first because the Parnate pooped out and had so many side effects . I do not think it will work as I have been retrying it every few years.
I just finished taking 4mg Sub to get enough pain relief tonight but at least I did not have to take the Lyrica. Sometimes I can go one day without it and still be in a flare and then again by tomorrow night I should know if these instills stopped the flare. I knew I would need more without the Lyrica. As long as my breathing stays okay
I have no RL support. Its me and my dogs. My family helps some financially but they are anything but supportive! I have a couple friends who try but they are ill equipped and I dont blame them. Well youve heard enough of my lifes story. You know I can tell tonight that I did not take the Lyrica. I am not in a complete fog. Now I can really be submersed in the depression!!
I hope things are going better for you. I know we have conversed or been involved in the same threads but I cannot recall much but I am familiar with your name. I apologize. It makes me cry not having a memory. I would usually look up all the threads we were both on and re familiarize myself but I do not have the energy. I dont think I will ever overcome this cognitive problems.What will I be willing to live with even if my mood improves? I dont have an answer yet. I have given up everything I ever aspired to. I dont live, I survive. It is getting old. Surviving without hope now. Thats an exaggeration. I still have a little hope or else I would not bother to try this stuff.
Im going on and on again.
Thanks again for the support. I appreciate it.
oky
Posted by kingcolon on September 21, 2008, at 15:45:59
In reply to Re: Does anyone have the original buprenorphine st » Quintal, posted by okydoky on September 20, 2008, at 23:20:23
I'd like to add my two cents. I've been on Subutex for a year with very good help and no tolerance at all. I use 4 to 6 mg daily, sublingual in divided doses. The original study by Bodkin used very tiny doses more along the line of those used for pain as opposed to those used for addiction maintance (eg, about 1-2 mg max.)I didn't find enough help at these low doses and I didn't have a history of chronic opiate use. So the jury is still out on the optimum dose for depression, and it may be that some people need doses of 8 mg or more. If lower doses are not helping, I think you should talk to your doc about gradually escalating the dose. Don't give up on it prematurely! I do think, however, it is not quite as strong a pain killer as MS or oxy, for chronic treatment. I also use the Sub in conjunction with Zoloft and Wellbutrin which I think significantly augment it's antidepressant effect.
Posted by Peter S. on September 21, 2008, at 22:51:30
In reply to Re: Does anyone have the original buprenorphine st » okydoky, posted by kingcolon on September 21, 2008, at 15:45:59
Hi kingcolon,
Glad to hear it works for you! Can you tell me how many times a day you're taking it? Also how long did it take before you noticed an anti-depressant effect?
Thanks
> I'd like to add my two cents. I've been on Subutex for a year with very good help and no tolerance at all. I use 4 to 6 mg daily, sublingual in divided doses. The original study by Bodkin used very tiny doses more along the line of those used for pain as opposed to those used for addiction maintance (eg, about 1-2 mg max.)I didn't find enough help at these low doses and I didn't have a history of chronic opiate use. So the jury is still out on the optimum dose for depression, and it may be that some people need doses of 8 mg or more. If lower doses are not helping, I think you should talk to your doc about gradually escalating the dose. Don't give up on it prematurely! I do think, however, it is not quite as strong a pain killer as MS or oxy, for chronic treatment. I also use the Sub in conjunction with Zoloft and Wellbutrin which I think significantly augment it's antidepressant effect.
Posted by kingcolon on September 22, 2008, at 0:26:47
In reply to Re: Does anyone have the original buprenorphine st, posted by Peter S. on September 21, 2008, at 22:51:30
Hi Peter,
I split the dose in two or three times a day intervals. The studies on depression, as well as for pain, seem to use split doses even though for addiction maintenance, a single daily dose is generally used. I think the biologic half-life is very short in comparison to the pharmacologic half-life. I do notice some "slipping" of mood toward the end of the dosing interval (say 6-10 hrs). The antidepressant effects did not occur instantaneously with me (unlike what is reported by others)--it took about a week to max out. There were anxiolytic effects almost immediately however. The sense of well-being it gave as well as it's motivating and anti-anhedonic effects have been the best of any medication I've taken over 15 years.
If others want to comment on their Sub experiences or add info on it, we should change the thread title since the original study was already referenced by undopaminergic.
Posted by okydoky on September 22, 2008, at 8:39:51
In reply to Buprenorphine experiences » Peter S., posted by kingcolon on September 22, 2008, at 0:26:47
Thanks for the input. Like every other narcotic I have taken it never lasts as long as the script says. Ive been taking 6-8mg day. Was supposed to be in two doses but I take 3mg and then at some point have breakthrough pain ( usually about 7 hours into the days first dose) and take 1 or 2 mg and then at 12 hours take 2 or 3mg for my last dose. I have been taking the naproxen with it to because the first day when i took 4mg my breathing was depressed so I thought I could not take enough for the pain. I will know more soon hopefully. I don't have a set amount yet because of the flare. Yesterday I had to take so much Lyrica I had no need for the second dose of Sub but I took it anyway. Can I ask exactly where you place the tab under your lip so that it dissolves the best and i don't end up swallowing some of it? It has been three days and the rawness is starting to where off. Not sure if it was withdrawal or what? I am definitely more anxious though. I have a definite need to take a tranquilizer. I have Klonopin and perphenazine at hand. completely or at least it seems so. Does anyone have an opinion as to whether Sub would be a better antidepressant than oxycontin or morphine or any of the opiates? I have more questions but I have to get my dog to the vet.
Thanks and talk later,
Okyp.s. as soon as my need for Lyrica is gone I will start on Amineptine I think.
Posted by kingcolon on September 22, 2008, at 11:17:00
In reply to Re: Buprenorphine experiences, posted by okydoky on September 22, 2008, at 8:39:51
You clearly need to take the Sub with a frequent dosing interval for pain relief. Anyone who's been using opioids chronically before starting Sub should find a dose that alleviates any withdrawal symptoms (eg, anxiety) before adjusting the dose further for pain or depression. This can be quite high (8 mg daily and higher) for some. However, most can cut back and get good control of both relapse and pain/depression with 8 mg or less. I've heard that some opioid addicts believe that "more is less" with this drug, in the long run, and that finding the minimum dose that helps is a good idea. For depression, I doubt that higher doses correlate with increased efficacy. I put Sub under the tongue in front and sort of clamp my tongue down on it while keeping my saliva "away" from there, holding it elsewhere in the mouth. I do this until the pill completely dissolves under the tongue which you can tell by moving your tongue over it and not feeling grittiness. This takes about 10 min for me, and sometimes I keep the remaining saliva in for a while longer, swishing it around.
As for Sub vs. oxy/MS, the fact that Sub has been effective even for ECT resistant depression suggests to me that it is at least as effective as the pure agonists for depression. Someone mentioned before that it has kappa antagonism, which oxy/MS doesn't, and this adds to it's antidepressant effects. What it isn't is a drug that makes you feel good because you're high on it(ie euphoric). (If you're dysthymic or dysphoric you will feel euthymic--in other words, "normal") Hope this helps a little.
KC> Thanks for the input. Like every other narcotic I have taken it never lasts as long as the script says. Ive been taking 6-8mg day. Was supposed to be in two doses but I take 3mg and then at some point have breakthrough pain ( usually about 7 hours into the days first dose) and take 1 or 2 mg and then at 12 hours take 2 or 3mg for my last dose. I have been taking the naproxen with it to because the first day when i took 4mg my breathing was depressed so I thought I could not take enough for the pain. I will know more soon hopefully. I don't have a set amount yet because of the flare. Yesterday I had to take so much Lyrica I had no need for the second dose of Sub but I took it anyway. Can I ask exactly where you place the tab under your lip so that it dissolves the best and i don't end up swallowing some of it? It has been three days and the rawness is starting to where off. Not sure if it was withdrawal or what? I am definitely more anxious though. I have a definite need to take a tranquilizer. I have Klonopin and perphenazine at hand. completely or at least it seems so. Does anyone have an opinion as to whether Sub would be a better antidepressant than oxycontin or morphine or any of the opiates? I have more questions but I have to get my dog to the vet.
>
> Thanks and talk later,
>
>
> Oky
>
> p.s. as soon as my need for Lyrica is gone I will start on Amineptine I think.
>
Posted by okydoky on September 22, 2008, at 16:50:35
In reply to Re: Buprenorphine experiences » okydoky, posted by kingcolon on September 22, 2008, at 11:17:00
Thanks. Of course every input helps. I'll try the under the tongue thing. What dose do you have? Mine are 2mg and taste like orange a bit. I guess when I taste it I think I am swallowing it. It is the third day and I am much calmer. No more jitters or sweats. I see that I will most likely not need as much as I thought the first two days but the dosing will have to be three times a day not two.
I felt like I could have gone completely without my first dose today. I only took 2mg. Its difficult when I am taking other pain meds with it. I will stop the Naproxen today. I tried to stop the Lyrica but I am still in a flare. The Pharmacy cannot fill my instills now. They cannot get the Heparin because of the recall I think. Everything is so difficult. I called a pharmacy that is an hour and a half away. If they can make it perhaps they can mail it. Or I can figure out how to write the script so I can get the stuff and compound it myself. I think they will stop the flare. I also got a script for an antibiotic. I asked for Levaquin but he prescribed Cipro. Last time I went through Cipro, Levaquin and then Levaquin twice a day. Does everyone think I am stupid??? What could I do I just took it. Maybe Ill get lucky this time. It is so hared to do anything. Why does everyone make it harder?
I just saw my new pcp who refused to prescribe Parnate. Said he never prescribes it, that he felt he had no control as I was asking him specifically for Parnate, would not take the methadone he prescribed and that he did not feel that my depression was bad enough to warrant such a drug. I guess I need to change pcp's. He said he would help me find a pdoc but I don't trust his judgment. Would you??? After I left I thought perhaps I should demonstrate to him and my family etc. just exactly how depressed I am. As long as I am fairly quite about it everyone seems to ignore or just not believe it. It is more convenient I guess.
Ok, I am venting I know. I appreciate the help.
A very frustrated,
oky
Posted by Peter S. on September 22, 2008, at 18:27:25
In reply to Buprenorphine experiences » Peter S., posted by kingcolon on September 22, 2008, at 0:26:47
Thanks for the response. What side effects have you experienced? Did you have any problems getting your doctor to prescribe it for depression? I'm wondering if I can get my HMO pdoc to go for it.
Regards,
Peter
> Hi Peter,
> I split the dose in two or three times a day intervals. The studies on depression, as well as for pain, seem to use split doses even though for addiction maintenance, a single daily dose is generally used. I think the biologic half-life is very short in comparison to the pharmacologic half-life. I do notice some "slipping" of mood toward the end of the dosing interval (say 6-10 hrs). The antidepressant effects did not occur instantaneously with me (unlike what is reported by others)--it took about a week to max out. There were anxiolytic effects almost immediately however. The sense of well-being it gave as well as it's motivating and anti-anhedonic effects have been the best of any medication I've taken over 15 years.
> If others want to comment on their Sub experiences or add info on it, we should change the thread title since the original study was already referenced by undopaminergic.
Posted by okydoky on September 22, 2008, at 22:56:27
In reply to Re: Buprenorphine experiences » kingcolon, posted by Peter S. on September 22, 2008, at 18:27:25
I just wanted to thank you guys for all the input. It was my doctors suggestion to try Bup but he would not prescribe it nor would any doc I spoke with. All the information from you on the board helped me. I emailed my doctor the DEA letter, a study about depression someone posted and a few other facts I picked up from you guys mostly and looking myself. Thanks to you he finally prescribed it. And thanks to you you continue to help me through how to take It and to be patient. I am not so nervous today and feel much better. I appreciate this support greatly. I have no real life support as everyone refers to it. It is just me and my dogs.
So thanks to all that have contributed to my well being. It is appreciated more than you can imagine. If it only lasts a day I will be as grateful as if it lasted forever.
I will continue to post how the Suboxone works for others to be informed.
oky
Posted by kingcolon on September 23, 2008, at 1:26:26
In reply to Re: Buprenorphine experiences » kingcolon, posted by Peter S. on September 22, 2008, at 18:27:25
I have a history of a relatively low level opiate dependence from 8 years ago, but have not had a relapse to date. However, my addiction was directly related to poorly responsive depression, which has persisted despite many meds. My psychiatrist and psychologist are both addiction specialists and have experience using bupe for their patients, and they also see quite a few people with dual disorders (depression+substance use). They knew of a number of their patients who showed remarkable improvement of depression with bupe, and advised me of this. That's how I got started on it. I continued some of my previous meds, but I'm going to try to eventually get off as many of them as I can without losing the benefits of combining them with bupe. I tried stopping Zoloft, but I felt it increased my irritability, so that failed. I think bupe does a great deal that other antidepressants don't, but not everything--it's mechanism is mostly related to dopaminergic activation, but it also effects glutamate and serotonin, so it is quite complex. As for side effects--the main one is constipation, but I'm using Miralax + one of the dissolvable fiber supplements and that takes care of it quite well. It can be sedating at first, but you adapt to it if you don't start on too high a dose, or slowly adjust the dose. Taking too much initially can cause nausea (worse than standard opioids! people use to get high). It's definitely not a drug to try to get high on by overdosing or you're likely to get significantly ill. Otherwise, to date I've had no bad side effects. I do find that using Wellbutrin with it minimizes any fatigue I may get.
> Thanks for the response. What side effects have you experienced? Did you have any problems getting your doctor to prescribe it for depression? I'm wondering if I can get my HMO pdoc to go for it.
>
> Regards,
>
> Peter
>
>
> > Hi Peter,
> > I split the dose in two or three times a day intervals. The studies on depression, as well as for pain, seem to use split doses even though for addiction maintenance, a single daily dose is generally used. I think the biologic half-life is very short in comparison to the pharmacologic half-life. I do notice some "slipping" of mood toward the end of the dosing interval (say 6-10 hrs). The antidepressant effects did not occur instantaneously with me (unlike what is reported by others)--it took about a week to max out. There were anxiolytic effects almost immediately however. The sense of well-being it gave as well as it's motivating and anti-anhedonic effects have been the best of any medication I've taken over 15 years.
> > If others want to comment on their Sub experiences or add info on it, we should change the thread title since the original study was already referenced by undopaminergic.
>
>
Posted by Peter S. on September 23, 2008, at 11:58:58
In reply to Re: Buprenorphine experiences » Peter S., posted by kingcolon on September 23, 2008, at 1:26:26
Thanks for the detailed info! I'm going to see what I can do to get a prescription. Since I've tried EVERYTHING I think I've got a good case for it as a last resort.
> I have a history of a relatively low level opiate dependence from 8 years ago, but have not had a relapse to date. However, my addiction was directly related to poorly responsive depression, which has persisted despite many meds. My psychiatrist and psychologist are both addiction specialists and have experience using bupe for their patients, and they also see quite a few people with dual disorders (depression+substance use). They knew of a number of their patients who showed remarkable improvement of depression with bupe, and advised me of this. That's how I got started on it. I continued some of my previous meds, but I'm going to try to eventually get off as many of them as I can without losing the benefits of combining them with bupe. I tried stopping Zoloft, but I felt it increased my irritability, so that failed. I think bupe does a great deal that other antidepressants don't, but not everything--it's mechanism is mostly related to dopaminergic activation, but it also effects glutamate and serotonin, so it is quite complex. As for side effects--the main one is constipation, but I'm using Miralax + one of the dissolvable fiber supplements and that takes care of it quite well. It can be sedating at first, but you adapt to it if you don't start on too high a dose, or slowly adjust the dose. Taking too much initially can cause nausea (worse than standard opioids! people use to get high). It's definitely not a drug to try to get high on by overdosing or you're likely to get significantly ill. Otherwise, to date I've had no bad side effects. I do find that using Wellbutrin with it minimizes any fatigue I may get.
>
>
> > Thanks for the response. What side effects have you experienced? Did you have any problems getting your doctor to prescribe it for depression? I'm wondering if I can get my HMO pdoc to go for it.
> >
> > Regards,
> >
> > Peter
> >
> >
> > > Hi Peter,
> > > I split the dose in two or three times a day intervals. The studies on depression, as well as for pain, seem to use split doses even though for addiction maintenance, a single daily dose is generally used. I think the biologic half-life is very short in comparison to the pharmacologic half-life. I do notice some "slipping" of mood toward the end of the dosing interval (say 6-10 hrs). The antidepressant effects did not occur instantaneously with me (unlike what is reported by others)--it took about a week to max out. There were anxiolytic effects almost immediately however. The sense of well-being it gave as well as it's motivating and anti-anhedonic effects have been the best of any medication I've taken over 15 years.
> > > If others want to comment on their Sub experiences or add info on it, we should change the thread title since the original study was already referenced by undopaminergic.
> >
> >
>
>
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