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Re: Ultram dose

Posted by loosmrbls on May 21, 2001, at 8:42:01

In reply to Re: Ultram dose Elizabeth, posted by Kristi on May 19, 2001, at 14:50:22

I appreciate that we can discuss this topic without it getting nasty.

I admit that most of my opinion about opiate drugs and depression comes from personal experience and is therefore limited.

One thing I want to describe is what I mean by "relieve" and "mask."

By "relieve" I did kind of mean cure, because antidepressant drugs are/were designed to correct chemical imbalances in the brain (monoamines -- dopamine/serotonin/norepinephrine) that are believed to play a primary role in the symptoms (if not cause) of depression. That would be a cure. Many people eventually come off of AD's without a recurrence of symptoms and never have another problem (I have a friend like that who took Zoloft). But obviously he does not represent the users of this forum.

By "mask" I mean induce a sense of euphoria -- much like alcohol does -- that does not address the problem but hides it. Just like opiates do not "cure" the cause of pain (like a broken bone) but "mask" the pain.

So in that sense, AD's "cure" depression (in theory) by working on the primary cause, while opiates "mask" it by relieving the pain.

Now, the arguement is can opiates "cure" depression -- can dysregulation in opiate receptors cause depression?

I admit it is entirely possible, if only in a small percentage of those depressed. I, like many people here, have suffered from a mood disorder for years (3), have been on multiple antidepressants with no success (often worsening), multiple mood stabilizers, and nothing has worked thus far.

I have cut myself only once in my life during a very bad depressive episode, have never felt the need to since. Someone mentioned naltrexone helping them -- I find that fascinating because naltrexone actually blocks opiate receptors, in effect "shutting down" the opiate pathways. This would actually suggest opiate excess.

And I know there are multiple subtypes of opiate receptors (at least four) and people respond differently to these drugs. My wife, for example, often gets nauseous and vomits at even a small dose.

While I have taken 120-180mg of codeine and noticed only a mildly calming effect.

OK, sorry for the long post. After three years of dealing with depression, I am coming to believe that "depression" is like a "fever", a common symptom (or syndrome) that can occur from any dysfunction of a chemical pathway within the brain -- and certainly opiate pathways can be one of them.

Thanks for the article citations.




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