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Re: Refractory depression--Elizabeth

Posted by Victoria on April 19, 1999, at 15:06:55

In reply to Re: Refractory depression--naltrexone, posted by Elizabeth on April 19, 1999, at 2:50:40

Elizabeth, Your symptoms sound very much like mine (except no panic disorder). The reference you made to chronic pain and sleep problems makes me think of my recent diagnosis of fibromyalgia (did we exchange posts on this a while ago)? Anyway, I'm currently doing much better on a combination of trazadone and serzone at night, and fairly agressive thyroid and hormone replacement (estrogen and testosterone--I'm older than you are). The more I learn about both depression and fibromyalgia, the more I believe they are related problems with brain chemistry. You might want to take a look at "Betrayal By the Brain" by Jay Goldstein, MD. One interesting overlap is that he claims to have a lot of success with fibromyalgia with neurontin and pindolol (among other things, he's got about 30 meds he works with). And lately I've been seeing more about both of those drugs as anti-depressants or augmenters of anti-depressants. I'm going to see Dr. Goldstein next month, so if I get good results, I'll let you know.

> Hi Jim. I did ask my doctor about ReVia, and he, as well as the consultant who originally recommended the buprenorphine, didn't seem to think it was such a hot idea. I would be interested to find out if anyone has a good idea of how opioid agonist responders fare on the pure antagonists, though.
> To anyone who's tried naltrexone, what sort of side effects did it have (and do you happen to know of any other common ones)? Given that I'm probably doomed to polypharmacy, I'd like to keep that sort of thing to a minimum.
> Back to Jim - your symptoms sound pretty much dissimilar to mine, which is discouraging. I have pretty much classic episodic melancholia, and panic disorder (which seems pretty easy to treat and as such isn't a big concern for me these days). No significant atypical features except for occasional bouts of social phobia, and as noted, no impulse-related symptoms. (In particular, despite having experimented with drugs and alcohol quite a lot in college, I've never had problems with addiction.) I've had depressions since adolescence (now nearly 23), and they've grown closer together and more severe over time. When depressed I tend to have early-morning insomnia (where I wake up feeling like sh*t), pronounced feelings of self-reproach and guilty ruminations, loss of pleasure, motivation, and interest, fatigue and feelings of being "slowed down," and appetite loss. I've also been battling chronic pain and sleep problems for quite a while.
> I was under the impression that naltrexone is rather long-acting, actually, and that q.o.d. dosing suffices for many. I could be thinking of something else, though.




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