Treating Depression with Opiods
David Schneider <Dave Schneider
There was a recent thread here on one type of opiate
treatment--buprenorphine. Go to http://www.deja.com/ and enter
"buprenorphine" in the quick search box, and you'll be able to read
the postings.
Dave
Jim Schott
the point where the controversy is not an issue with me. Is there anyone in
the group who is sucessfully being treated by a professional with opiods?
... and is willing to talk about it!
Elizabeth
>Treating depression with opiods is a very controversial subject, but I am at
>the point where the controversy is not an issue with me. Is there anyone in
>the group who is sucessfully being treated by a professional with opiods?
Sure. What do you want to know?
-elizabeth
-elizabeth
There's a time and a place for everything, and it's called college.
-- _South Park_
Jim Schott
1) How far on the fringe is treating depression with opiods? Are we talking
1%, 5% or more of the depressed population being treated with opiods?
2) Just as there are market leaders for depression (Prozac, Paxil, Zoloft,
etc), are there also market leaders for opiods that have worked best
experientially?
3) If I go down the opiod path, are the chances of addiction quite high,
moderate, low, or non-existent?
4) How does one go about finding an MD who is willing to treat depression
with opiods?
Any help with the above will be most appreciated!
"Elizabeth" <cyber...@paultopia.net> wrote in message
news:87scuf$t7p$1...@nntp3.atl.mindspring.net...
Elizabeth
>Elizabeth: The following are some questions that pop right up:
>
>1) How far on the fringe is treating depression with opiods? Are we talking
>1%, 5% or more of the depressed population being treated with opiods?
Less, I'd guess (at least, "officially" -- I'm sure many people are
self-medicating, either illegally or by using drugs that were prescribed for
pain).
>2) Just as there are market leaders for depression (Prozac, Paxil, Zoloft,
>etc), are there also market leaders for opiods that have worked best
>experientially?
Buprenorphine is popular among MDs because it's supposedly less addictive
than other opioids. It also is long-acting -- about 8 hours -- so it doesn't
need to be taken as often as others. Buprenex can be taken 3 times a day,
whereas immediate-release morphine might need to be taken 5 times a day or
more. Morphine and oxycodone both are available in slow-release
preparations, so they are probably good choices too. (I found MS Contin less
effective than Buprenex, however -- just my personal experience.)
>3) If I go down the opiod path, are the chances of addiction quite high,
>moderate, low, or non-existent?
That depends on you. For clues, look at your family history and personal
history of addiction and other compulsive behaviors.
>4) How does one go about finding an MD who is willing to treat depression
>with opiods?
I don't know...one just sort of fell into my lap. (Not literally. :->) I
think it's important to have a mutually trusting relationship with your pdoc
so it's clear that you're not "drug seeking" or whatever.
Jim Schott
"Elizabeth" <cyber...@paultopia.net> wrote in message
news:87ta86$pbp$2...@nntp8.atl.mindspring.net...
Lews
mistaken, one gradually builds up a tolerance to opiods requiring a
gradual increase in dose to maintain the same effect. This makes me
think long term use would not be a viable option.
--
Regards,
LEWS
Garland Hopkins
narcotic addiction through the course of their lives and also achieved a
lot and contributed a lot to science. Who were they, ..if you guessed
doctors and surgeons your right.
Garland Hopkins
mailto:garl...@home.com
http://garland.galacticworlds.com
Garland Hopkins
mailto:garl...@home.com
http://garland.galacticworlds.com
LostboyinNC
Garland Hopkins <garl...@home.com> wrote:
> There is lots of antedotal information about professionals who
maintained
> narcotic addiction through the course of their lives and also
achieved a
> lot and contributed a lot to science. Who were they, ..if you guessed
> doctors and surgeons your right.
I think the name of this board should be changed
to "alt.support.IwanttoCreatemore.Problemsformyself"
Im very skeptical about the efficacy of narcotics for depression...in
short I dont believe it. All they do is give you a buzz and kill pain.
I was on Percocet last June for a purely pain related condition...it
worked GREAT for the pain, but it also made me drowsy, buzzed and gave
me a "rebound" worsened depression effect the next morning when I woke
up.
Garland, nobody in there right mind wants to be a narcotics addict.
Depressed people already have enough problems. There are other options
besides narcotics and just "stoning" yourself all the time.
Narcotics can CAUSE depression...did you know that?
--
regards,
Eric the Psycho
Steroids caused my depression...prednisone should be used conservatively
Beware of steroids!!!!
Sent via Deja.com http://www.deja.com/
Before you buy.
Amos
others have said to me, and from what I have read, people generally
don't develop tolerance the antidepressant effect of opioids, even if
they do to other effects.
Amos
Elizabeth
>Is long-term treatment of depression with opiods feasible? If I'm not
>mistaken, one gradually builds up a tolerance to opiods requiring a
>gradual increase in dose to maintain the same effect. This makes me
>think long term use would not be a viable option.
Opioids have a variety of effects, and people do become tolerant to some of
them (e.g., pain, euphoria). The antidepressant effect, however, seems to be
sustained. (Unfortunately, most of the nasty side effects are sustained as
well.)
My therapist reports having used morphine 150mg/day for depression without
seeing any "dosage creep."
Mike Burgess
LostboyinNC <lostb...@my-deja.com> wrote in message
news:88c2mo$mj2$1...@nnrp1.deja.com...
> Im very skeptical about the efficacy of narcotics for depression...in
> short I dont believe it. All they do is give you a buzz and kill pain.
> I was on Percocet last June for a purely pain related condition...it
> worked GREAT for the pain, but it also made me drowsy, buzzed and gave
> me a "rebound" worsened depression effect the next morning when I woke
> up.
>
> Garland, nobody in there right mind wants to be a narcotics addict.
> Depressed people already have enough problems. There are other options
> besides narcotics and just "stoning" yourself all the time.
>
> Narcotics can CAUSE depression...did you know that?
>
>
> --
> regards,
>
> Eric the Psycho
Eric, where do you get all this 'information' that you try to pass off as
'fact' on this NG? I hate to jump onto the 'WE HATE ERIC' bandwagon but, if
you don't really know much about a particular area, try silence...or at
least qualify your statements a little instead of making outrageously broad
generalizations. Personally, I've found (after my 10 years of college and 3
degrees) that I can better distinguish between areas about which I know
something from those about which I know little. (Moral: try some FORMAL
education).
LostboyinNC
> Eric, where do you get all this 'information' that you try to pass
off as
> 'fact' on this NG? I hate to jump onto the 'WE HATE ERIC' bandwagon
but, if
> you don't really know much about a particular area, try silence...or
at
> least qualify your statements a little instead of making outrageously
broad
> generalizations. Personally, I've found (after my 10 years of
college and 3
> degrees) that I can better distinguish between areas about which I
know
> something from those about which I know little. (Moral: try some
FORMAL
> education).
>
>
--Mike, where do you come off telling me that I have no knowledge? I
have formal education also...I have a BA. What are your three degrees
in Mike? Underwater basketweaving? Gay and lesbian studies? I dont
appreciate you calling me uneducated with all my personal experience
with clinical depression and medications. Ive read a lot also. Asked
plenty of questions. I dont know what your problem is but narcotics are
not very useful to treat depression. I tried Percocet and it made my
depression worse. I dont like to hear all the hype about opiates for
depression because I know it is mostly bs. Just like you are probably
mostly full of bs Mike.
Fairplay Mahubah
>He doe's provide a great deal of comic relief. His theory about self
>administering electric shocks with a police stun gun cheered me up for days. I
>still get a chuckle thinking about him tied to his bed and leaning his forehead
>into a stun gun.
Did he really? Is this satire?
I can't help wondering if my grasp of reality is slipping just a
little on this one. But then I'm nuts so maybe this is normal -- it's
the confusion that bothers me.
>Just remember that whenever he sounds so rude ...he is a self-proclaimed
>psycho-retard whose system has become a toxic stew of ADs and Steroids. So be
>gentle with him.
>
>To get the full effect of his humor potential, ..just read his messages in the
>voice of Cartman from South Park. You'll get a quicker lift than any of the
>ADs.
>
>Garland Hopkins
>mailto:garl...@home.com
>http://garland.galacticworlds.com
>
>Norman Dryden wrote:
>
>> LostboyinNC wrote in message <88k1eg$a2t$1...@nnrp1.deja.com>...
>> >--Mike, where do you come off telling me that I have no knowledge? I
>> >have formal education also...I have a BA. What are your three degrees
>> >in Mike? Underwater basketweaving? Gay and lesbian studies? I dont
>> >appreciate you calling me uneducated with all my personal experience
>> >with clinical depression and medications. Ive read a lot also. Asked
>> >plenty of questions. I dont know what your problem is but narcotics are
>> >not very useful to treat depression. I tried Percocet and it made my
>> >depression worse. I dont like to hear all the hype about opiates for
>> >depression because I know it is mostly bs. Just like you are probably
>> >mostly full of bs Mike.
>> >
>> >regards,
>> >
>> >Eric the Psycho
>>
>> Eric,
>> You may have good knowledge and education but it doesn't show in the way you
>> present yourself. This is a support group where people, who may be new and
>> nervous contributors, are free to seek help and ask any level of question,
>> no matter how naive, and to receive friendly and helpful advice.
>> That ideal is constantly violated by your inappropriate overbearing manner.
>>
>> Expressions such as 'come on dude', 'that's bullshit', 'what a wussy',
>> 'tough shit sherlock', etc. together with your overstated views on
>> particular drugs, and your overbearing views on alternative therapies, are
>> simply not appropriate on a 'support' group. By all means state your case,
>> but there is no point in being aggressive. No-one will listen to you or take
>> your advice if it is presented in this manner.
>>
>> You have constantly and consistently spoiled the whole tone of this group
>> and constantly offend individual contributors. You don't even see how
>> immature it is to give reasoned advice, which you sometimes do, and then
>> sign it
>> 'Eric the Psycho'
>>
>> You claim to be educated, but seem to think education consists of having
>> knowledge and qualifications.Tthat's only half the equation. Educated people
>> also know how to present their views reasonably, treat others considerately,
>> tolerate views which are contrary to their own, and debate things in a
>> friendly manner.
>>
>> Maybe you could start by considering this advice rather than labelling it
>> bullshit. Shouting that you are educated and knowledgeable doesn't count -
>> you have to show that you are.
>>
>> Regards,
>>
>> Norman
fairplay_nospam_..@primemail.com
Good luck is when preparation meets opportunity.
Garland Hopkins
Elizabeth
>Elizabeth wrote in message <87ta86$pbp$2...@nntp8.atl.mindspring.net>...
>
> > I think it's important to have a mutually trusting relationship
> > with your pdoc so it's clear that you're not "drug seeking"
> > or whatever.
>
A good, long psychoanalysis! :-)
Seriously, I wonder that myself. Apparently "drug-seeking behavior" is not
the same thing as going out looking for drugs.
Has anyone ever read a piece of work called _The Asylum_ about a couple
doctors who pretend to be psychotic in order to infiltrate a psych ward? I
have no idea where one would find a copy, but it sounds hilarious
(apparently their charts included phrases such as "note-taking behavior,"
which presumably is something different from just writing stuff down).
LostboyinNC
Norman, you sound so serious. I temper my posts with a lot of sarcasm,
stupidity and a warped sense of humor. It is my own way of keeping my
sanity...trying to at least. Remember the saying "you have to be crazy
to stay sane?" Well that describes me perfectly these days. I have to
be warped to relieve pressure and stress. I seriously doubt from the
tone of your posts and the way you sound that you understand where I am
coming from. Perhaps you are too busy listening to classical music or
Bach or something to understand this. But thats OK because I could
almost guarantee I know WAY more about depression, psych meds and
treatment than you do. After all Ive been through hell in the past two
years and am treatment resistant.
You obviously are way too serious to appreciate a warped sense of
humor. You also cant read between the lines. You are probably just
another nerd on here...Ive noticed nerds get depressed a lot. Maybe its
cause they are so introverted and have no friends I dont know. Just
remember this NG is not a college paper or something...it does not
matter here the way you write. But you sound so serious that you
probably need an enema or something. Mr. serious...do you have a butler
and everything too?
You need to get real and realize this clinical depression stuff is VERY
serious business. I cut through the crap on here because Ive been
through the mill with these asshole doctors and psychiatry in general.
Im tired of it and when I see something that relates to depression
which is STUPID...in my own direct, blunt, frontal assault method I
want to destroy it. Norman, why bullshit around when you can do things
directly? Always be direct...its the best thing any of us can do.
Eaton T. Fores
> Has anyone ever read a piece of work called _The Asylum_ about a
> couple doctors who pretend to be psychotic in order to infiltrate a
> psych ward? I have no idea where one would find a copy, but it sounds
> hilarious (apparently their charts included phrases such as "note-taking
> behavior," which presumably is something different from just writing
> stuff down).
This sounds a lot like D. L. Rosenhan's famous early 70s paper, "On Being
Sane In Insane Places," which documented just such an experiment.
ETF
Elizabeth
>This sounds a lot like D. L. Rosenhan's famous early 70s paper, "On Being
>Sane In Insane Places," which documented just such an experiment.
Yes, I believe that's it. I'll ask my pdoc (he's the one who mentioned it to
me).
Eaton T. Fores
> Apparently "drug-seeking behavior" is not
> the same thing as going out looking for drugs.
It is really strange. A psychiatrist friend was recently telling me
enthusiastically about how some of his patients were very happy with a
certain new antipsychotic drug, and he was just pushing the dose at their
request. He seemed undisturbed, even pleased, by this. I mentioned that if
the drug had been a controlled substance, he would have been alarmed that
patients liked it, and under no circumstances would he have increased the
dose in accord with the patient's wishes. But the difference between a
controlled substance and an ordinary legend drug is not a pharmacological
one, it's a political one -- "controlled substanceness" does not name a
chemical feature of molecules -- and so this behavior on the doctor's part
is entirely irrational. With some controlled substances (e.g.,
sibutramine), one can only wonder, "Huh? What on earth were they thinking,
assuming that they were thinking at all?" (sibutramine [Meridia] is
pharmacodynamically identical to venlafaxine, but it is much more potent and
longer acting -- which to me suggests that its use in depression should be
preferred to the use of venlafaxine [Effexor]). But because it is marketed
as a "diet pill" rather than an "antidepressant," it gets slapped with the
C-IV. But the decision about which market to target a given compound at is
a marketing decision, not a pharmacological fact. Sibutramine isn't an
antidepressant simply because some bean-counters decided that there were too
many antidepressants already, and that with the phen-fen debacle, there was
a nice market opening for a diet pill (sibutramine isn't effective as a diet
pill, BTW, but what the hell? Drugs these days don't need to be effective;
they just have to be free of adverse effects).
"Drug-seeking behavior" is exactly what psychiatrists want; it's their bread
and butter. What they *don't* want is "controlled substance seeking
behavior."
ETF
Eaton T. Fores
> it sounds hilarious (apparently their charts included phrases
> such as "note-taking behavior," which presumably is something
> different from just writing stuff down).
I don't know about you, Elizabeth. You seem to be exhibiting an awful lot
of "newsgroup posting behavior" :-)
ETF
phoebes
wrote:
>Has anyone ever read a piece of work called _The Asylum_ about a couple
>doctors who pretend to be psychotic in order to infiltrate a psych ward? I
>have no idea where one would find a copy, but it sounds hilarious
>(apparently their charts included phrases such as "note-taking behavior,"
>which presumably is something different from just writing stuff down).
Believe it or not, I've witnessed this. I believe it's an OCD but I
could be wrong. While in hospital years ago there was a woman there
who obsessively took notes, writing on anything she could find. She
literally was constanly writing things down. No one knew exactly what
she was writing (well, her doctors did obviously).
phoebes
DCDJC
>From: LostboyinNC
Eric, is it EVER possible to penetrate your very thick skull with the notion
that
**YOUR PERSONAL EXPERIENCES DO NOT CONSTITUTE WISDOM" ?
Time after time, someone comments on a topic. You jump in claiming that
someone else's opinion or experience is invalid just because YOU did not
benefit from trying it (or something you read said otherwise).
You are not the center of the universe. Your experiences are not
universal; I agree with Sean and others that they may not even be real. But in
any event, stop acting like a tin god proclaiming "THAT DOESN"T WORK" of "THAT
WILL BE BAD FOR YOU" just because you supposedly had such reactions. Are you
too dumb to understand this concept? Are you saying that everyone who reports
affirmatively about one of these modes of treatment is lying, and that you are
the sole possessor of the truth? How humble of you.
By the way, in what area of study did you obtain your college degree? Did
you obtain it in any subject that makes you an expert on psychopharmacology?
From your posts it would seem most likely that your degree was in Phy.Ed.,
maybe with a minor in body building and a number of courses in bullshit. You
certainly never took (or passed) a course in logic. Try it some time: it can be
invigorating to those poor depressed brain cells you tell us so much about.
dcdjc
phot...@my-deja.com
"Jim Schott" <jsc...@home.com> wrote:
> Treating depression with opiods is a very controversial subject, but
I am at
> the point where the controversy is not an issue with me. Is there
anyone in
> the group who is sucessfully being treated by a professional with
opiods?
> ... and is willing to talk about it!
>
>
that naturaly work as an anti-depressant. I have tried the lot of anti-
depressants and I consider SSRI's such as Prozac and Paxil crude. Yeah,
they work to some extent but I can become the most insensitive bastard
in the world on these drugs. They arnt natural, they simply block all
emotional responses. Opiates on the other hand although highly adictive
and probably a dangerous route to take if your severaly depressed, they
make me feel just normal. I rarely take a doses which give a
significant buzz, I beleave with some opiates one can get anti-
depressant effects without the buzz. Codeine is great opiate to start
experimenting with although not really ideal because of its short half
life. But it can be used to determine if your a person suited to
opiates, because some people simply arnt.
As for doctors prescribing opiates, it doesnt seem likely at least
where I am from. I self medicate on a couple of different opiates and
i'm sure many others do. Its not the best way to go but for me
personaly it is the only way. Until I get proper professional help for
the rest of my psychological problems. People who do choose to self
medicate would obviously need to be self deciplined, its ever so
tempting to take more and more until tolerance gets out of hand.
Tolerance developing is inevitable but it can be limited to a large
extent through careful use of the drug. Remember its the anti-
depressant effects we want from the drug not the buzz.
Amos
> experimenting with although not really ideal because of its short half
> life.
What sort of dose of codeine is a good idea as a "tester"?
Amos
phot...@my-deja.com
For someobody with no tollerance to opiates, between 120mg to 180mg.
However a large factor is down to the individuals size. I know people
who has noticed mood changes on as little as 90mg. Another thing to
take into consideration with codeine is that a certain percentage of
the white population is alergic to codeine. That is they lack a certain
enyzme which metabolises codeine to morphine. This is something like
7%. This is unlikely to happen but should be taken into account when
somebody finds that codeine doesnt appear to work and they feel sickly
on relatively short doses.
James Simpson
news:88mhdh$74i$1...@nntp9.atl.mindspring.net...
>(sibutramine [Meridia] is pharmacodynamically identical to venlafaxine,
>but it is much more potent and longer acting -- which to me suggests
>that its use in depression should be preferred to the use of venlafaxine
> [Effexor]). But because it is marketed as a "diet pill" rather than an
>"antidepressant," it gets slapped with the C-IV.
I've wondered this myself. Meridia does *not* cause release of dopamine,
unlike amphetamines or other diet pills which cause release. It behaves
identically to other AD's, in blocking reuptake only. Meridia has a
different ordered potency for blocking reuptake of neurotransmitters --
norepinephrine>serotonin>dopamine (with Effexor it's
serotonin>norepinephrine>dopamine, and high doses are required to work on
norepi/dopamine). Meridia also blocks dopamine reuptake more potently than
Effexor, which would likely be good for someone with very low energy level.
It also seems to have less severe side effects than Effexor, less dry mouth
etc., and I don't believe it's effect on the heart is any worse than
Effexor's. So why isn't it used for depression? It seems like it would
possibly be a more potent AD, since it blocks reuptake of all 3 major
neurotransmitters, as opposed to the "specific" reuptake inhibitors. Has
anyone here tried Meridia for depression?
James
-- "Dr. Benway reeled back and flattened against the wall, a bloody scalpel
clutched in one hand. 'Get me a new scapel, this one's got no edge to
it!'". -- William Burroughs
Tracy Ann Bernson
However, it made me feel awful. Heartracing, dizziness, edgy.. Nothing I have
exprienced before. It also raises one's blood pressure. I personally wouldn't
recommend it. [And, after losing all that weight, I developed numerous
gallstones, and had to have my gallbladder taken out.. and gained all the
weight back.]
James Simpson wrote:
--
Elizabeth
>Not for depression. But for weightloss. I lost 40 lbs on it in 5 months.
>However, it made me feel awful. Heartracing, dizziness, edgy.. Nothing I have
>exprienced before. It also raises one's blood pressure. I personally wouldn't
>recommend it. [And, after losing all that weight, I developed numerous
>gallstones, and had to have my gallbladder taken out.. and gained all the
>weight back.]
Ow! :-(
FWIW, Effexor can also cause the side effects you describe, including
sustained hypertension. How high was your BP?
-elizabeth
"You're the guy who runs to a 7-11 to get Satan a pack of cigarettes."
- _The West Wing_
Tracy
Another interesting point is that Merida is given at very low doses -- 5, 10, 15 mg. No higher. What
type of dosing is Effexor?
Elizabeth wrote:
--
Elizabeth
>I am lucky that I have low blood pressure so my increase only put me in the
>normal range.
>
>Another interesting point is that Merida is given at very low doses -- 5, 10,
>15 mg. No higher. What
>type of dosing is Effexor?
Doesn't matter...they're not equipotent. 10mg of Meridia does not = 10mg of
Effexor.
But the effective dose range for Effexor is somewhere around 75-400mg.