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Re: Whats the best opiate for depression ? » shelliR

Posted by Elizabeth on May 9, 2001, at 15:07:05

In reply to Re: Whats the best opiate for depression ? » Elizabeth, posted by shelliR on May 7, 2001, at 11:15:59

> I talked to Dr. Bodkin for about three minutes and he's the one who told me that the selegiline patch was due to come out. He said he'd talk to me again when he got back from being out of town, but so far no luck.

Yeah, he's been super-busy lately (he's not even taking any new patients except experimental subjects). So he's hard to reach. I spoke to him for just a couple minutes becuase I needed a referral.

> So I called Dr. Lukas (same hospital, same studies) and it was his secretary that told me to e-mail him.

Scott Lukas? I know him! He teaches a class on substance dependence. I think he's actually a PhD -- a *real* pharmacologist. < g >

> I asked him about opiates and also exactly when the patch was due out. IF I hear from him, I'll let you know what he says.

More perspectives are always welcome!

> Do you think Bodkin is worth having a consultation with? (I'd have to come up from Washington, D.C.).

I don't know if he'd even have time to see you! He's quite busy, as you've noticed.

> I don't have anyone to try different optiates with me here. I will look up tramadol, because I don't know anything about it. But even if that's what Bodkin would recommend, I'm not sure he'd write me prescriptions (since I'd only be going for a consult), and my pdoc down here (who I never see--just renews my prescriptions) is okay with me taking a small dose of hydrocodone, but won't prescribe it.

The idea of a consultation is, you go see the consultant, and the consultant speaks to your regular psychiatrist and makes recommendations as to your treatment. Yes, given your situation, I think a consultation (with Bodkin or, if he's too busy, with another doctor -- I'm sure he can make a good referral) would be worthwhile.

> So basically, I feel like I am my own pdoc now.

I know...I've had that feeling many times...like, nobody's there to help me so I have to just do my best to help myself.

> Your clarification on habituation vs addition led to my doing a lot of reading on the subject. Basically, I ended up feeling a lot better about the whole thing. So thanks.

You're welcome! I'm glad it had the desired reuslt.

> One question I asked Dr. Lukus was, besides eliminating food interactions, if there was any anti-depressant advantage to the patch.

It's supposed to start working quite fast.

> Selegiline is a reversible MAOI, right?

No. It's an irreversible one, preferentially inhibiting type B (but becoming nonselective at higher doses).

> So I was curious to know how it compares to nardil or parnate orally in terms of anti-depressant value for treatment resistent depression. My guess is that I would not be a good candidate for it, but I'm curious what he will say, if I do indeed get an answer.

I did try high-dose oral selegiline (for 6 weeks or so), but the results were less than stellar. It made me jittery, that was about it. (Kind of like Wellbutrin.) Maybe I wasn't taking enough.

Elizabeth


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poster:Elizabeth thread:61760
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