Posted by Elizabeth on May 19, 2001, at 14:25:39
In reply to Re: Ultram, selegiline » Elizabeth, posted by shelliR on May 18, 2001, at 20:55:55
> How do you take it?
Intranasally.
The alternative would be deep intramuscular injections, but I don't know if that is really safe to do on a thrice-daily basis in the long term.
> I am feeling too many ups and downs with hydrocodone. Sometimes when I take it, it does give me a bit of a high.
That's something that doesn't happen with buprenorphine. But because it's short acting (and the duration isn't 100% predictable), once it starts wearing off, I start getting really fatigued (or sometimes, irritable).
> Also sometimes it sets in very quickly and other times it takes up to an hour.
I'd think that would have to do with things like whether you've eaten recently, the pH of your stomach, etc.
Intranasal buprenorphine consistently takes about 1 hour to start working, which is very inconvenient if I forget to take it on time.
> Basically, that's what I feel about hydocodone in general-that I can't really get a handle on it and I still don't feel the kind of right that I felt when nardil was working.
The trick is to take it frequently enough that you achieve steady state levels (so that you never feel it wearing off). Alternatively, if you could find a somewhat effective AD that wouldn't stop working like Nardil did (that happened to me too, BTW), you might be able to take the hydrocodone intermittently rather than taking it around the clock.
> Still I am grateful, because I believe it is keeping me alive.
I understand.
> I may try ultram even though it is not recommended with an MAOI. It is a more "be careful warning" than a "do not take warning".
Umm...I wouldn't try it. Remember that there's no guaranteed treatment for serotonin syndrome. I think the risk is too great with MAOIs, but it might be worthwhile to mix it with SRIs. The problem, as I see it, is that you risk having a reaction each time you take it, and you'd be taking it pretty much around the clock (right?).
> I have mixed about everything with nardil (including demerol during an exploratory procedure) and no reactions until I tried nardil with adrafinil. My blood pressure went up to 165, not dangerous, but a bit scarey compared to my usual 90-110.
I take it you mean your systolic BP? < g > Yeah, 165 is not high enough that it would cause any damage. I once had a reaction associated with fava beans (don't ask how I came to be eating those without realising it) that resulted in a hemorrhage in my right lung, but my BP was something like 240/120.
> Now I have a blood pressure monitor which makes me feel more secure.
That's good, although it's possible to get obsessive about checking your BP.
One time I checked mine while at a party, and a whole bunch of people wanted to find out what theirs were. Great icebreaker, huh?
> I can tell something is happening because my pulse starts falling. (I have no idea medically why that is.)
It's an attempt to compensate for the constriction of your blood vessels (by slowing the rate at which blood is pumped through them).
> But hopefully with ultram---if I can take it--I will not get any high.
I doubt it. Ultram is a really weak opioid, and there's a pretty strict limit on how much you can take -- 400mg daily. I'm just guessing, but I think very few doctors would be willing to prescribe more than that. In the PDR, it's not just the recommended dose range. The exact phrasing in the PDR is: "...50 mg to 100 mg can be administered as needed for relief every four to six hours, not to exceed 400 mg per day." ("not to exceed 400 mg per day" is in boldface.)
> Because I have a dissociative disorder, the person I am most familiar with at McLean is Dr. Chou who used to be the head of whatever they call the dissociative disorders or trauma unit there.
I met him once; I think he was the head of Proctor 2, the dissociative disorders/trauma unit.
> ...my therp says all people with dissociative disorders also have major depression.
Really? I always thought of dissociation as more of an anxiety-trauma related thing.
> My assumption is that Dr. Bodkin doesn't have anything to do with either outpatient or inpatient treatment at McLean--that he is only involved with research. Is this the correct assumption?
He might still be seeing patients who he's been seeing for a long time, and I think he still does consultations. But you're right, AFAIK he is mainly involved in research.
> As for the patch you mentioned, I can't imagine anyone giving it to me and it sounds pretty complicated (e.g., could give out before 72 hours, but still have to wait, etc.).
Duragesic (fentanyl)? Yes, sometimes it doesn't last as long as it's supposed to. I don't know anybody who's used it solely for depression, but I did once meet someone with chronic pain and depression who said she didn't need to take other ADs once she was using the fentanyl patch.
> Anyway, any info on buprenorphine would be greatly appreciated.
Sure, always glad to help if I can...any specific questions?
-elizabeth
poster:Elizabeth
thread:61760
URL: http://www.dr-bob.org/babble/20010515/msgs/63637.html