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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by EllisDee on January 14, 2010, at 19:40:13
I stopped a 2 year script of suboxone cold turkey (hell, but paid the piper) in summer of 09...been on wellbutrin(for 3 months and weaned off easily), one dose of effexor (not for me)...so doc said if its not my thyroid then let's try MAOI, namingly parnate...been on a month now and its done nothing but make me pass out (dizzy) and have hearing loss...food restrictions suck too...I'm a healthy mid 30's guy w/ family...I wanna know if I'll have any withdrawals after one month @ 40mgs and this last week @ 20>30mgs a day depending on dizzy spells...I know, call my doc...but I like to research on my own and wean to nothing before I get deep...I'm suffering from PAWS and am on 6 months with only reverting back to pain pills being any comfort (perfect/no buzz comfort actually) but that ship has sailed and I'm clean but lethargic...because of my past addiction to pills I hide opiate use from everyone...but its truly the only thing that makes me feel normal...but I know I can't go that route ever again.
Any advice?
Posted by EllisDee on January 14, 2010, at 19:45:38
In reply to stopping parnate after 1 month, posted by EllisDee on January 14, 2010, at 19:40:13
I guess I'm also asking for a PAWS treatment besides time.
Posted by emmanuel98 on January 14, 2010, at 21:12:26
In reply to Re: stopping parnate after 1 month, posted by EllisDee on January 14, 2010, at 19:45:38
What is PAWS?
Posted by Phillipa on January 15, 2010, at 10:48:25
In reply to Re: stopping parnate after 1 month, posted by emmanuel98 on January 14, 2010, at 21:12:26
I thought I was the only one what is PAWS? Phillipa
Posted by MoonageDaydream on January 15, 2010, at 15:59:07
In reply to stopping parnate after 1 month, posted by EllisDee on January 14, 2010, at 19:40:13
PAWS is Post-Acute Withdrawal Syndrome.
http://en.wikipedia.org/wiki/Post_Acute_Withdrawal_Syndrome
How long were you taking Suboxone, and at what dose? Did you taper at all?
Have you taken any pain pills since getting off it?
Posted by bleauberry on January 15, 2010, at 16:04:58
In reply to stopping parnate after 1 month, posted by EllisDee on January 14, 2010, at 19:40:13
I think you will have withdrawals and to be psychologically prepared for that would be wise. For me...very tiny doses very short time...withdrawals began about 3 days after last dose and included very uncomfortable anxiety and depression. I didn't have any physical withdrawals.
Your history indicates your symptoms are within the endorphin circuits. At other forums, past opiate users said they got similar or better results with LDN. The difference is that LDN is very slow...weeks to several months. It naturally builds up your endorphins and resets a lot of things including the endorphin circuitry and receptors.
LDN is low dose Naltrexone. Generally 1.5mg to 4.5mg at bedtime. So it has to be made at a compounding pharmacy since the smallest pill is 50mg. Some people take even less, and some people take it every other day instead of daily. The trick with it is to give it lots of time.
Another endorphin helper is DL-Phenylalanine, starting with tiny doses...50mg (much lower than advertised doses) away from food. This will also make more dopamine and norepinephrine, which if that is not good for you (jittery, irritable) then you would want to switch to D-Phenylalanine. It prevents the breakdown of your own natural endorphins.
Though not directly related to the opioid systems, medications that have suspected interplay include Milnacipran, Tramadol, Effexor, Remeron, and some of the tricyclics.
I've seen at other forums where past opiate users found Tramadol to be the best antidepressant. They admit it comes with an addiction issue and horrid withdrawals if stopped, but tolerance is controlled by taking drug holidays weekly or monthly for a day to three at a time. Unlike antidepressants, Tramadol works when you come back to it after taking a break. They gladly accept addiction over crushing depression. Tramadol is much tamer than the heavy hitting opiates and is cheap.
I'm not surprised Parnate didn't do much for you, since it wasn't acting on the circuits that have proven to be your target...your endorphins.
If you want minimum side effects, natural repair of your opioid system, then LDN would be a good one. Just be prepared to stay with it for months. It is not like a drug really, but more like a longterm construction/repair team. If it helps but still falls short of your goal, then a little bit of DLPA or DPA, or a small dose of a choice antidepressant, would go well with it in synergy.
This is the end of the thread.
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