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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 5 to 29 of 29. Go back in thread:
Posted by Phillipa on January 24, 2009, at 20:31:10
In reply to Re: Endogenous Depression Caused By Lack Of Endorphins, posted by bulldog2 on January 24, 2009, at 18:05:20
I feel admin should be the judge of where I do or do not post??? Blueberry is right. Phillipa ps a lot of us have different views. And Where Have I expressed that I do not take conventional meds? I remember when we were on the same med. Love Phillipa
Posted by Phillipa on January 24, 2009, at 20:35:24
In reply to Re: Endogenous Depression Caused By Lack Of Endorphins, posted by bleauberry on January 24, 2009, at 17:08:50
BB currently corresponding with a person on LDN. Didn't know about the timing. Must inform person also. Thanks. So far just that one LLMD around here???? Love Phillipa ps also endo said excercise daily for stabalizing thyroid. How do you feel about this?
Posted by Sigismund on January 25, 2009, at 0:41:24
In reply to Endogenous Depression Caused By Lack Of Endorphins, posted by Phillipa on January 24, 2009, at 12:29:33
People in opiate withdrawal are of course seriously depressed.
You try to work (or to find) the toaster.
Something goes wrong and it doesn't work.
You sink to the floor.
(How dramatic, but true.)
Posted by SLS on January 25, 2009, at 6:48:15
In reply to Endogenous Depression Caused By Lack Of Endorphins, posted by Phillipa on January 24, 2009, at 12:29:33
I am usually skeptical when there is a report of a newly discovered cause for depression - especially when the explanation involves a single substance without discussing brain circuits. I am more likely to pay attention to a conclusion that something has been found to be associated with depression, even though a causal relationship has not been established. Either way, I am interested to know more about this association.
- Scott
Posted by Garnet71 on January 25, 2009, at 7:32:52
In reply to Endogenous Depression Caused By Lack Of Endorphins, posted by Phillipa on January 24, 2009, at 12:29:33
I've thought of this (aside from the science perspective) but mistakenly referred to dopamine when I mean endorphines. I'm not into the technical terms, and don't care to learn them right now.
I too feel a lack of endorphines. Yes, Phillipa, exercise is the best. Could you do the eliptical or exercise bike with your back problems? Swimming? The problem for other people is that they cannot get the energy to exercise because of the depresion. I've been there so many times. I'm back to exercising again.Sex makes me feel like I have endorphines in my brain. In fact, I stayed in a bad relationship - emotionally abusive - partly because the sex was so good and frequent (he had a very high sex drive). I think I was addicted to this person. I felt high around him, especially during sex. It is a physical feeling of euphoria in my brain. It has taken me so much to stay away from him. Every time I tell him to get lost, he slowly crept his way back into my life. I believe he was a narcissist and was very charming, sensual, and pretend sweet, and used sex to manipulate me. Enough already.
Food - like comfort foods and sweets and carbs make me feel like there are endorphines in my brain.
Rollercoasters, going fast in a plane, turbulence, little thrills - same thing.
Money - same thing. If I get to spend money on nice things, which is very rare, I feel 'happy'.
I used to feel endorphines when I listened to music. That joy has gone, but since I quit taking antidepressants,I noticed I am liking music again,but not as much as I used to.
It sounds pathetic, but really, I can feel a euphoria in my brain from these things. IT's a physical feeling that generates "happiness". I am assuming it is endorphines that cause the euphoric feeling - but I really don't know. I do know my body though, am very self aware.
Maybe this is behind addictive personalities. I don't know. I'm not addicted to drugs or alcohol gambling or sex - but I could easily become an alcholic - my father was one - I stay away. Or a compulsive gambler - I don't have money to gamble so again I stay away. I quit smoking. I do compulsive eating now - it used to be the only thing t stop the anxiety (when doctors wouldnt prescribe the apprpriate meds) - and now it seems to be a permanent problem.
I know true joy comes from within - but why these little highs? Does this mean I have an addictive personality, or do I lack endorphines in my brain? Don't normal people feel eurphoric at times?
Posted by Garnet71 on January 25, 2009, at 7:36:36
In reply to Re: Endogenous Depression Caused By Lack Of Endorphins, posted by bleauberry on January 24, 2009, at 17:08:50
> You can take low dose (1.5mg to 4.5mg) Naltrexone between 9pm and 12pm each night to increase endorphins. The drug temporarily tricks the opioid receptors into thinking there isn't enough endorphins, so for a few hours it pumps out a bunch of new ones which last about a day and this accumulates over days and weeks.
>
> DL-phenylalanine can also work by preventing the breakdown of existing endorphins. Or just pure D-Phenylalanine, but it is expensive.
>
> But we both know this isn't your problem so I'm not sure why you were surfing upon it. You should be out there researching docs Phillipa! :-) Come on already. :-)
>
> Actually, low dose naltrexone has been said to help Lyme sufferers because it beefs up and resets the immune system.-------------------------------
Bleauberry - do you know more about his drug? I read up on it on Wiki...and about how it was used for drug addiction recovery - but I didn't find a good site. Do you know about its side effects?This is the first drug I'v been interested in for a long time now. I think I want to try it - how do pdocs feel about prescribing this (in general)?
The PDoc I am going back to in 2 weeks has always frowned upon alternative meds like when I brought up St. Johns Wort...and this is a pharmaceutical so maybe he will be more receptive..but this is an alternative use.. Thanks
Posted by bulldog2 on January 25, 2009, at 8:38:45
In reply to Re: Endogenous Depression Caused By Lack Of Endorphins » bulldog2, posted by Phillipa on January 24, 2009, at 20:31:10
> I feel admin should be the judge of where I do or do not post??? Blueberry is right. Phillipa ps a lot of us have different views. And Where Have I expressed that I do not take conventional meds? I remember when we were on the same med. Love Phillipa
You have the right to post whereever you want but my point is you might be looking in the wrong place for lyme's disease and thyroid. You have stated recently that you do not wish to try new meds any more and mess with your brain.
Posted by desolationrower on January 25, 2009, at 11:25:38
In reply to Re: Endogenous Depression Caused By Lack Of Endorphins, posted by bulldog2 on January 25, 2009, at 8:38:45
Ashwagandha increases opioid receptor sensitivity. however i think it also does something with thyroid.
i think there are others, can't remember them right now though.
-d/r
Posted by Phillipa on January 25, 2009, at 12:47:20
In reply to Re: Endogenous Depression Caused By Lack Of Endorphins » Phillipa, posted by Garnet71 on January 25, 2009, at 7:32:52
I know what you mean and I sure think normal people feel these little highs for me used to be often not anymore they used to hold me for a few days. I do ride my bike six miles shire force to do it but am always glad afterwards like getting in the car and going out and accomplishing something . Only thing doesn't last. Am now going to take care of that matter and thanks by the way Phillipa
Posted by Phillipa on January 25, 2009, at 13:01:25
In reply to Re: Endogenous Depression Caused By Lack Of Endorphins, posted by bulldog2 on January 25, 2009, at 8:38:45
I don't remember posting that openly on the board could you point me to the link much appreciated. Phillipa Anyway still looking and trying different things.
Posted by Phillipa on January 25, 2009, at 19:45:45
In reply to Re: Endogenous Depression Caused By Lack Of Endorphins » bulldog2, posted by Phillipa on January 25, 2009, at 13:01:25
I have to wonder if no taste or spell is interfering with plesure centers as a passion of mine was reading and eating chips and salsa no more what's the point? Think I will google for a list of endorphins and post it. Phillipa
Posted by Phillipa on January 25, 2009, at 20:05:08
In reply to Re: Endogenous Depression Caused By Lack Of Endorphins, posted by Phillipa on January 25, 2009, at 19:45:45
Well I'll be darned!!!! Phillipa
http://www.medicinenet.com/script/main/art.asp?articlekey=55001
Posted by Garnet71 on January 25, 2009, at 22:41:50
In reply to Re: Endogenous Depression Caused By Lack Of Endorphins, posted by Phillipa on January 25, 2009, at 20:05:08
I read that article and found several more...Now I know for sure I am not crazy. Guess what foods I have made just this week - Indian and Mexican food..Guess what I made a special trip to the store to buy just 3 days ago - you guessed it - Mexican chocolate (with Capscian and 80% Coaco-the high endorphine foods so the articles say). I have been craving these foods for years, and it's getting out of hand. But I only discovered Mexican chocolate last summer - and have frequently bought it ever since. I also crave orgasms -more than what is normal - as embarassed as I am to say.
I've felt for quite some time there is something wrong with the endorphines in my brain - I just haven't found the words to describe it
I seriously don't know how much more of this I can take. I have an appointment with pdoc in 2 weeks - I am fearing they will listen to me for a whole 2 minutes, then get out their prescription pad for Zoloft - Effoxor, or Prozac as usual. I can't take it anymore. And with that, I want to f*ing die. Not in a suicidal sense - I just cant take the torture anymore and it seems as if that is the only way it will end.
Posted by Phillipa on January 26, 2009, at 0:47:31
In reply to Re: Endogenous Depression Caused By Lack Of Endorphins » Phillipa, posted by Garnet71 on January 25, 2009, at 22:41:50
Lindtt dark chocolate my vice. Love Phillipa
Posted by mav27 on January 26, 2009, at 2:46:12
In reply to Re: Endogenous Depression Caused By Lack Of Endorphins » Garnet71, posted by Phillipa on January 26, 2009, at 0:47:31
yukky.. i hate dark chocolate :)
I have survived the last 8 years on chocolate and pepsi.. i would have about 1 to 1 1/2 large 250gram blocks a day plus a few cans of pepsi.. now at 28 years old im paying for it teeth that arn't happy with me plus other health problems. I've given up both for the last 2 years and have tried to be treated again with medication but nothing is working like good ol' chocolate did :(
Posted by Phillipa on January 26, 2009, at 20:17:27
In reply to Re: Endogenous Depression Caused By Lack Of Endorphins » Phillipa, posted by mav27 on January 26, 2009, at 2:46:12
Mav you serious? Since lost taste and smell five years ago at least a bit of taste from dark chocolate. Love Phillipa
Posted by 4WD on January 27, 2009, at 0:20:01
In reply to Re: Endogenous Depression Caused By Lack Of Endorphins » mav27, posted by Phillipa on January 26, 2009, at 20:17:27
Hi everyone,
I haven't posted for a while but the reason Phillipa is asking about it is because she and I have been emailing about it. My doctor (not my pdoc, my family doctor) has diagnosed me as having genetic or endogenous endorphin deficiency. I have just begun seeing an addictions specialist because I have been using opiods to get the endorphins to kick in and can't get off them because the withdrawal is so horrible - I fall into total, suicidal despair and because on opiates I feel energetic, motivated and happy. My depression goes away, my anxiety is cut by 9/10s and I generally feel like a normal person when I take Percocet. Trouble is, tolerance and my usage is getting out of hand.
The new doctor I am seeing will be treating me with Subutex or Suboxone. Which is better?
I definitely am a substance abuser - have been self medicating with narcotics off and on for years. Had three years of total abstinence March 05 through June 08 when I broke my back and had to be exposed to narcotics again. As soon as I started taking them, I felt normal again (depression persisted the whole time I was clean). So for the first couple of weeks after starting on Percocet I was able to take it as prescribed but then the whole craving/obsession thing was reawakened and I've been battling with it ever since.
The new doctor I am seeing held a seminar last week. I attended and he was talking about endorphins. I raised my hand and told him my doctor had diagnosed me with genetic endorphin deficiency. He told the class that my doctor was a very wise man who kept up with the literature because endogenous endorphin deficiency was on the cutting edge of neuroscience right now.
I truly believe that is what is wrong with me and been wrong with me all my life. I was put on ADs at age 13. The only times I've felt normal and whole was when I first started Geodon (lasted about 6 months then pooped out) and when I first started Nardil - got some mild hypomania for a few weeks, then went away and depression started returning. I was dealing with it the best I could then I broke my back and voila! problem solved. I had an excuse to take pain meds and my life and enjoyment of it returned to normal immediately. Unfortunately my abuse returned as well. Well, it's not really abuse, I guess, it's self medicating and needing more than originally prescribed because of tolerance issue.
I start the Subutex therapy on Thursday or Friday. Will post again and let you all know how it goes and if the doctor I am seeing for the subutex therapy has more to say about endorphin deficiency.
Marsha
Posted by mav27 on January 27, 2009, at 0:57:21
In reply to Re: Endogenous Depression Caused By Lack Of Endorphins, posted by 4WD on January 27, 2009, at 0:20:01
Was there any specific tests done such as blood tests ect for your doc to come to the conclusion he did or is it just something that needs to be diagnosed based off symptoms ect?
Posted by Phillipa on January 27, 2009, at 12:13:39
In reply to Re: Endogenous Depression Caused By Lack Of Endorphins » 4WD, posted by mav27 on January 27, 2009, at 0:57:21
Mav maybe history and behavior based. 4wheel drive will be back to report. She's a wonderful caring person. Phillipa
Posted by 4WD on January 28, 2009, at 0:09:09
In reply to Re: Endogenous Depression Caused By Lack Of Endorphins » 4WD, posted by mav27 on January 27, 2009, at 0:57:21
> Was there any specific tests done such as blood tests ect for your doc to come to the conclusion he did or is it just something that needs to be diagnosed based off symptoms ect?
My pdoc referred me to this doctor because I have been taking lots of opiates for the past few months. Everytime I try to quit, I can't get past the withdrawal stage because I get so severely depressed. So the buprenorphine is being prescribed to get me off the Percocet. Percocet has been giving me the endorphins I need to stay functional but my tolerance keeps increasing and I am tired of the cycle of dependence and all the issues involved with abusing, yes, abusing opiates. I have been taking more than I need to stay out of depression. My hope is that the buprenorphine will allow me to get through withdrawal and off the pain meds and hopefully have the benefit of treating my treatment resistant depression and natual lack of endorphins.
I start the medication on Friday. Until then I will stay on the Percocet. This program involves a lot more than just getting a prescription once a month. I will have to drive an hour every M, W and F to attend a three hour group session 9am-12. This will go on for 6-8weeks. It's basically an outpatient rehab.
Marsha
Posted by SLS on January 28, 2009, at 7:57:32
In reply to Re: Endogenous Depression Caused By Lack Of Endorphins » mav27, posted by 4WD on January 28, 2009, at 0:09:09
Hi Marsha.
Gosh, it has been such a long, hard road for you. I am glad you finally found an answer.
I can't comment on the desirability of taking straight buprenorphine (Subutex) versus the mixture of buprenorphine and naloxone (Suboxone). I just don't know. If cravings are an issue for you, perhaps the Suboxone will be considered first.
- Scott
Posted by 4WD on January 28, 2009, at 22:22:27
In reply to Re: Endogenous Depression Caused By Lack Of Endorphins » 4WD, posted by SLS on January 28, 2009, at 7:57:32
Hi Scott,
It's good to hear from you. I thought I'd be getting my prescription at my meeting today but instead they told me they wanted to coordinate meds from my pdoc first. I don't know exactly what they mean by that - they primarily gave me a note to take to the family doc who has been giving me the Percocet so he would have something official in hand telling him that I didn't receive my RX today like I thought I would and so would need to continue the Percocet for a few days longer. Until I saw the note, they hadn't told me when I would be starting.
I still don't know whether they will give me Subutex or Suboxone but a couple of people in group this morning told me that straight Subutex also blocks opiate receptors. I'm not so sure about that so I think I'd prefer the Suboxone. The only reason I wouldn't is that I have been on Naltrexone before (I think it was 50mg a day) and it made me nauseated. I told them that at my evaluation so they are still deciding. But then, narcotics used to make me nauseated - I'd always have to take a tiny bit of Phenergan with my opiates or I'd be very sick. But now opiates don't make me nauseated at all. So I could probably take the Suboxone. If they give me Subutex instead, I would be tempted to try out the theory that it blocks opiate receptors so I think Suboxone is the better idea for me.
BTW, Scott, thanks for acknowledging that I've had a long, hard road. But you know that nobody has had a longer, harder road than you. Thanks for not being judgmental at all about the narcotics addiction - generally people who are not addicts or never been addicted to anything or experienced cravings and obsession, don't understand why you can't just make up your mind and quit. Thanks for understanding.
My tolerance has continued to creep up. I'm now taking 80-100mg a day of Percocet and a dose wears off after about 3 hours. It scares me how much I'm taking and I was so looking forward to getting my Rx today and having it over with. OTOH, it gives me a few more days to enjoy the Percocet motivation and energy - I don't know how I'll feel on Subutex but Percocet is a sure thing. So I have very mixed emotions about having to wait to begin.
I'll get my script on Feb. 2nd and take it to the pharmacy that day. They will have it in late the next day - too late for me to start taking it that day so I got Rx's from my family doc through the 4th. So I'll be starting the buprenorphrine on Feb. 5. My first day clean in several weeks now.
I don't know how many of you out there pray or have a relationship with God, but those of you who do (and even, if you will, those of you who don't) please pray for me that the Subutex works and the withdrawal from narcotics is mitigated by the Subutex and that I get the motivation and energy I need from my new med.
Marsha
> Hi Marsha.
>
> Gosh, it has been such a long, hard road for you. I am glad you finally found an answer.
>
> I can't comment on the desirability of taking straight buprenorphine (Subutex) versus the mixture of buprenorphine and naloxone (Suboxone). I just don't know. If cravings are an issue for you, perhaps the Suboxone will be considered first.
>
>
> - Scott
Posted by SLS on January 29, 2009, at 7:08:03
In reply to Re: Endogenous Depression Caused By Lack Of Endorphins » SLS, posted by 4WD on January 28, 2009, at 22:22:27
After doing a wee bit of reading, I see that Subutex might be better-suited for your condition than Suboxone. Naloxone is added to the buprenorphine in Suboxone ONLY to prevent I.V. abuse. If administered I.V., the naloxone induces a withdrawal episode rather than a euphoriant effect.
Buprenorphine is a partial agonist at mu and kappa opioid receptors and a full antagonist at delta receptors. I believe that it is the partial agonism at the mu receptor that places a ceiling on the perception of euphoria, unlike complete agonists like heroin. It doesn't appear that naloxone is necessary in non-I.V. opioid users.
Although I'm feeling pretty good and probably won't need opioids for my treatment, I wish my doctor had been receptive to the idea of using buprenorphine when I presented it to him. You are very fortunate.
I look forward to seeing how you respond to buprenorphine.
Take care.
- Scott
Posted by 4WD on January 31, 2009, at 2:04:40
In reply to Re: Endogenous Depression Caused By Lack Of Endorphins » 4WD, posted by SLS on January 29, 2009, at 7:08:03
Thanks for the info Scott. I am hoping they will put me on Subutex. I told them at my evaluation that I had been on Naltrexone before and it made me nauseated so maybe they will take that into consideration. I will know for sure Monday since that is when I will receive my script for the meds.
My pdoc is not the one who is prescribing the buprenorphine for me. What happened is a miracle from God. The family doctor who has been maintaining me on Percocet insisted I call my pdoc and tell him it was an emergency. I called him (and this just happened to be on a Thursday, the one day I can reach him for sure. He called me back right away (another miracle). I told him what was going on: that I was addicted to the pain meds and wanted desperately to get off them but couldn't because every time I tried to quit, the withdrawal caused suicidal depression. So he said he had someone in mind for me to see; the clinic where I see him is not licensed to prescribe buprenorphine. He called an addictionologist, Dr. Rick Beach. who he said was the best in the field and talked to him about me. My pdoc told Dr. Beach that I was highly motivated and a good candidate for treatment. Then my pdoc called me back and gave me his phone number and told me they were waiting for my call. I called and took the first available appt. which was only about 10 days away (I had been afraid I'd have to wait a month to get in). Then I attended a seminar about a week later and got some good information, although he talked a lot about chronic pain. (Most of the people he treats have become addicted to narcotics due to chronic pain. I have had chronic pain since I broke my back last summer but my pain is not that bad - addiction is my primary problem).
Well, I went for my appt. and was accepted as a candidate for treatment. It involves a lot more than just going once a month for the script for the meds. I have to drive an hour and 15 minutes each way on Mondays, Wednesdays and Fridays for a three hour group therapy session and I have to be there by 9. Which is difficult because I can't go to sleep before about 2 because of the narcotics I am taking. But I already see that the group therapy is benefiting me so I'm glad they are making me do it.
I will turn the script in to the pharmacy on Monday afternoon and they will order it that day. It should be there by Tuesday late or Wednesday. So I went back to my family doctor and he gave me a new set of scripts through Wednesday to maintain me until I can be sure I have the Subutex in my hand. I won't be able to start it until the day after I get it because I wake up in withdrawal every morning and can't wait without taking something for long enough for that day's pharmacy order to arrive.
So everything is all set. I get the script on Monday for sure and start taking the med on Thursday. It's possible I will have the med on Tuesday and could start Wednesday but like the typical addict, I don't think I will have the strength to not get that last prescription filled. I prayed tonight that God would give me the courage to cancel that last script if I had the Subutex earlier than Wednesday - I won't be able to do it myself.
I will keep you all posted on how the therapy goes. I was told they had to coordinate my current psychiatric meds with my pdoc and that's why I'm not getting the script til Monday. It scares me a little bit - what if they want to take me off something that I know I need to keep taking? Like Geodon or Xanax. Well, I will worry about that when and if it happens. As I said, I will keep y'all posted on how the treatment goes.
In the back of my mind, I am hoping it will feel just like Percocet but I think I am placing too high expectations on the bupe. I should be grateful if it does nothing more than get me clean without having to go through the despair of withdrawal. But supposedly it "tricks" the brain into producing more endorphins so I am hoping that it will relieve my depression and give me energy and motivation - exactly what the Percocet does for me.
Marsha
> After doing a wee bit of reading, I see that Subutex might be better-suited for your condition than Suboxone. Naloxone is added to the buprenorphine in Suboxone ONLY to prevent I.V. abuse. If administered I.V., the naloxone induces a withdrawal episode rather than a euphoriant effect.
>
> Buprenorphine is a partial agonist at mu and kappa opioid receptors and a full antagonist at delta receptors. I believe that it is the partial agonism at the mu receptor that places a ceiling on the perception of euphoria, unlike complete agonists like heroin. It doesn't appear that naloxone is necessary in non-I.V. opioid users.
>
> Although I'm feeling pretty good and probably won't need opioids for my treatment, I wish my doctor had been receptive to the idea of using buprenorphine when I presented it to him. You are very fortunate.
>
> I look forward to seeing how you respond to buprenorphine.
>
> Take care.
>
>
> - Scott
>
Posted by sunkistcat79 on February 3, 2009, at 0:43:02
In reply to Re: Endogenous Depression Caused By Lack Of Endorphins, posted by 4WD on January 27, 2009, at 0:20:01
Hi there,
I have a similar experience as you. How is the treatment going? There was somethign wrong and I was unable to read the rest of the thread.You can read about my experiences on this site. I think it IS great that you have a doctor that was able to diagnose you as such. I'm pretty desperately looking for a docotr like that for right now.
Just 2 days ago, in the midst of a VERY VERY severe and long (20 years)depression, I had to start treating myself again with buprenorphine (subutex - I had taken it before and have a bunch left over). I started with .5 mg and then took another .5 mg 30 minutes later.
I was unable to find any other opioids to take and then withdraw from PRIOR to restarting taking bupe.(as you are supposed to) and have been very very sick ever since. I'm taking about .5 mg to 1 mg every 12 hours and things are very bad.
I dont know if I should increase my dose (I'm scared to...) or stop.
Oh, and please dont tell me that was a stupid thing to do - I know it wasn't the BEST option. But my prescribing doctor is basically ignoring me and it was either this or something else....much worse. (When you have suffered with untreatable depression for LITERALLY 2/3 of your entire life, that "much worse" becomes much more viable).
And 4WD, sorry, I didnt' mean to take over your thread with my problems...
I can barely sit at the computer and type cuz of the naseau and I just needed to get it out there while I could...for the moment.
This is the end of the thread.
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