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Re: Suboxone???? Is it only for Opiates or an Ad T undopaminergic

Posted by Crotale on June 2, 2008, at 16:31:20

In reply to Re: Suboxone???? Is it only for Opiates or an Ad T, posted by undopaminergic on June 1, 2008, at 19:52:44

> In general, the antidepressant doses of buprenorphine (BUP) have all been less than 4 mg, but the optimal (or useful) range of doses for this purpose hasn't really been sufficiently investigated.

I only take a total of 1.2mg/day (in divided doses of 0.3mg q.i.d.). The high doses prescribed to addicts are partially to block the effects of heroin or other opioids, as you say. But another reason for prescribing such high doses is because people who are addicted to opioids are liable to have a high tolerance, so the lower doses won't be effective for them.

> If you wish to explore, use whatever dose of BUP is effective enough for your pain.

For pain (if you aren't tolerant) the lower doses should be sufficient. I don't know off the top of my head what the dose equivalence is for oxycodone, but for morphine it's 15mg MS = 0.3mg BUP (both IM), according to the PDR.

> If you would rather stick to doses that have been found efficacious in depression, use up to about 4 mg of BUP, in combination with another opiate, such as oxycodone, for additional pain control, as required.

Why do you suggest another opioid? Additional buprenorphine should work for breakthrough pain.

> Low doses of BUP combine well with other opioids, whereas high doses will antagonise their effects.

I once received MS Contin with buprenorphine (same dose as now -- I've been taking Buprenex for quite a few years & haven't needed to increase it). I found the MS Contin didn't work.

Crotale


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URL: http://www.dr-bob.org/babble/20080528/msgs/832539.html