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Re: Codeine for Depression Treatment » shelliR

Posted by Elizabeth on June 7, 2001, at 1:47:06

In reply to Re: Codeine for Depression Treatment » Elizabeth, posted by shelliR on June 6, 2001, at 22:04:45

> Thanks for the information, Elizabeth. Actually I have no choice but to self-medicate. My pdoc says it's okay to take the hydorcodone but he won't prescribe it. My gyn will give me enough for 10 days for pms symptoms, but that's it. And I don't believe that I will find a pdoc who will prescribe hyrodocodone for depression (even Dr. bodkin won't anymore).

I know of a few doctors who've used opioids with success. It might help if you pitched Ultram to them -- there's been a bit of work with it for depression, social phobia, and OCD. Anyway, as long as a doctor knows you're taking it and what dose you're taking, that's fine. Just don't start self-adjusting your dose or whatever.

> I am planning to ask my pdoc about Buprenorphine, which I may have a better chance of getting from a doctor.

Not from a pdoc. Buprenorphine makes them squeamish because it only comes in the injectible solution and even if you aren't injecting it, you need to use a syringe to take it.

> I think I am self-prescribing, rather than self-medicating, in a sense.

Hence, taking the wrong dose of codeine.

> But because opiates are so often addictive drugs, doctors other than pain management doctors have to be really careful.

Pain management doctors too.

> I think I mentioned before that my gyn told me that doctors are very carefully monitored for these drugs and she said it is the most common way that doctors get warnings and lose their licenses.

I know. It's terrible.

> When I was a very young adult and severely depressed (pre-prozac) my pdoc gave me tricyclics and I couldn't take them. They completely disoriented me. I ended up in the hospital (Sheppard-Pratt, supposed to be a good hospital) and again they gave me tricyclics, and again I couldn't adjust. Neither my pdoc or the pdocs in the hospital even suggested a MAOI.

Wow. I didn't like the side effects of TCAs either, but they were nothing compared to opioids.

> Right after my hospital stay, absolutely on a fluke, I happened to catch Nathan Kline on PBS, and bought his little paperback book (From Sad to Glad).

Careful, you're dating yourself. ;-)

> I asked my pdoc why she hadn't put me on one of them and she sort of hemmed and hawed and said, "oh, yes, that was going to be my next suggestion." Like right, thanks. So basically at the age of 22 I felt that I saved my own life because I just happened to have been lucky. And I have never ever put my life totally in the hands of any doctor, without doing my own research. It's much easier now, but there were times I spent entire days at the library at NIH.

I know how you feel. Due to bad past experiences, I have a certain distrust of pdocs (well, more a "trust but verify" mentality) that makes it hard for me to work with them. I always come in with a list of things I want to do, they always want to hear lots of history and stuff. I should just make a writeup.

> I had a pdoc for ten years who is considered the best in the city with treatment resistent depression. She would not even read any of the McLean studies on opiates.

She wouldn't even *read* them? What kind of doctor is that?

> Over and over I heard definitively that codeine is not an anti-depressant. So although my preference would be collaboration with a pdoc, I'll take my chances with supervised self-medication.

Codeine is a crappy opiate, not the one I would choose if I felt a full agonist were appropriate. How did you come to be switched to that from the hydro?

-elizabeth


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poster:Elizabeth thread:64320
URL: http://www.dr-bob.org/babble/20010605/msgs/65631.html