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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Babak on September 23, 2011, at 14:20:41
Hi
I have suffered from depression since I my teens (I am now 52).
I started on ADs(Prozac) when I got to 30 after a nervous break down.
I started taking pain killers as a way of dealing with headaches and other symptoms of Prozac. It got worse when I switched to Effexor which was more effective in dealing with my lack of drive but had more side effects.
Then I developed these bad stomach pain which were probably already symptoms of withdrawal. But they were so bad that I ended up on Morphine Sulphate which helped with my depression as well. By then I was hooked.
Anyway I have been on Methadone for the last three years now and I have tried so many times to reduce my dose but in the absence of another solution to my depression( anhedonia and lack of drive) I have had to increase it again.
I started at 50 at which dose my depression was a lot better but as I reduced it down to 15 my depression got worse and worse. I can't tell that I was in withdrawal because my symptoms were nothing like those of opiate withdrawal but I got progressively depressed, found it difficult to concentrate or enjoy anything and I became more and more reclusive and unsociable.
Obviously I am worried about developing more tolerant with higher doses and end up just as depressed but some people tell me that my psychological symptoms are to do with the fact that I am not taking enough Methadone and the is therapeutic dose is between 60 to 120ml.
I have no craving for heroin or any other drug.
So is there a chance that if I increase my intake to 60ml that my depression will stabilize for good until I can work and save up enough money to try this Dr. Waimsann method to come off the damn thing for good because I have tried going without it after cutting it down to 5ml but I started having psychotic thoughts and was convinced that I had to kill myself in order to be reborn again without depression. I ended up in hospital.
Posted by sigismund on September 23, 2011, at 14:42:33
In reply to What is meant by therapeutic dose of Methadone, posted by Babak on September 23, 2011, at 14:20:41
Always take the minimum of methadone, if you can.
It is so hard to give up.
And being on it induces a low grade depression, although that sounds different to what you have.
I was on it for ages, just ages.
Posted by sigismund on September 23, 2011, at 15:05:47
In reply to What is meant by therapeutic dose of Methadone, posted by Babak on September 23, 2011, at 14:20:41
>but as I reduced it down to 15 my depression got worse and worse.
15mg/d is where things start to get hard, and it gets harder. For some reason around 7.5mg/d was very hard for me. I spent about 3 years going from 2.5mg/d to zero, so that wasn't too hard in the longest and slowest titration in history.
Posted by Babak on September 23, 2011, at 15:31:40
In reply to Re: What is meant by therapeutic dose of Methadone » Babak, posted by sigismund on September 23, 2011, at 15:05:47
> >but as I reduced it down to 15 my depression got worse and worse.
>
> 15mg/d is where things start to get hard, and it gets harder. For some reason around 7.5mg/d was very hard for me. I spent about 3 years going from 2.5mg/d to zero, so that wasn't too hard in the longest and slowest titration in history.what do you mean by things start to get hard? Do you mean depression or withdrawal symptoms?
Posted by sigismund on September 23, 2011, at 17:04:41
In reply to Re: What is meant by therapeutic dose of Methadone, posted by Babak on September 23, 2011, at 15:31:40
>what do you mean by things start to get hard? Do you mean depression or withdrawal symptoms?
It depends entirely on the rate of withdrawal. If fast enough, you will get both. But it is different for everyone.
Posted by sigismund on September 23, 2011, at 17:08:39
In reply to Re: What is meant by therapeutic dose of Methadone » Babak, posted by sigismund on September 23, 2011, at 17:04:41
If you are already depressed, depression with be worse during withdrawal, just as if you are in pain, pain will be worse during withdrawal.
Posted by sigismund on September 23, 2011, at 22:00:55
In reply to Re: What is meant by therapeutic dose of Methadone, posted by sigismund on September 23, 2011, at 17:08:39
You may be interested in some of the links in this post.
I find the one on methadone and memantine difficult to believe, but.........
Posted by sigismund on September 23, 2011, at 22:03:13
In reply to Re: What is meant by therapeutic dose of Methadone, posted by sigismund on September 23, 2011, at 22:00:55
It doesn't open now. It used to be there; I've read it. Basically it is about people on doses of methadone such as to yours using memantine to withdraw without difficulty.
Posted by Babak on September 24, 2011, at 5:25:30
In reply to Re: What is meant by therapeutic dose of Methadone, posted by sigismund on September 23, 2011, at 22:00:55
"Some combination of dopaminergic drugs is quite likely to effectively replace the dopaminergic effects of opioids, but unfortunately not the analgesic effects. Or did you find the dopamine agonists to be effective pain-killers?"
That is exactly what I had hoped for.
My fear is that I increase the Methadone back to 50 or even 60 and then develop tolerance to that without my depression getting any better in the long run.
I have lost hope with SSRIs and SNRIs and I think the increase of anhedonia is at least partially due to them especially Paxil.
Posted by Babak on September 24, 2011, at 5:38:32
In reply to Re: What is meant by therapeutic dose of Methadone, posted by sigismund on September 23, 2011, at 22:00:55
"Some combination of dopaminergic drugs is quite likely to effectively replace the dopaminergic effects of opioids, but unfortunately not the analgesic effects. Or did you find the dopamine agonists to be effective pain-killers?"
That is exactly what I had hoped for.
My fear is that I increase the Methadone back to 50 or even 60 and then develop tolerance to that without my depression getting any better in the long run.
I have lost hope with SSRIs and SNRIs and I think the increase of anhedonia is at least partially due to them especially Paxil.
Posted by sigismund on September 24, 2011, at 12:42:16
In reply to Re: What is meant by therapeutic dose of Methadone » sigismund, posted by Babak on September 24, 2011, at 5:25:30
>My fear is that I increase the Methadone back to 50 or even 60 and then develop tolerance to that without my depression getting any better in the long run.
That is what will happen. Higher doses of methadone are not better. If I had a favourite dose it was 20. I still got some effects but the sweating and general unhealthiness were not so severe.
You know how strong methadone is, don't you? What 10mg is like for someone who is opiate naive? So at 50, there is quite a load, and there is toxicity.
Yeah, I'm with you on SSRIs and SNRIs. Or at least I wanted to spare myself that. I did try a tiny dose of milnacipran.
This is the end of the thread.
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