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Re: naltrexone » shelliR

Posted by Elizabeth on November 9, 2001, at 22:19:42

In reply to Re: naltrexone » Elizabeth, posted by shelliR on November 9, 2001, at 12:19:42

> Well, of course I don't know. :-). But if Dr. Bodkin also tried naltrexone, then I would assume he was going for the same effect as my pdoc.

Maybe, maybe not. Remember that Bodkin is primarily a researcher.

> It must affect the same cells to make codeine-like drugs ineffective.

It nonselectively antagonizes opioid receptors. (BTW, morphine, not codeine (which just gets turned into morphine anyway), is considered the prototype opioid receptor agonist.)

> Why are pdocs proscribing naltrexone for depression at all? I mean what is the thinking in terms of that drug affecting depression, given the fact that it is an antagonist?

No clue -- maybe up-regulation of opioid receptors over the long term?

> That would be interesting, although with my one day horrible experience with naltrexone, I would not be the first to volunteer.

This would be using doses so small you probably wouldn't even notice them. You probably got 25 mg pills; the dose you'd use to prevent tolerance is in the microgram range (don't recall any more precisely, sorry).

> Right now I am totally freaking out about the cost of oxycontin.

You're not the only one! :-)

> I had never gotten more than a week of it before and never really thought about the expense. Wednesday night I went to fill a whole month's dose, plus concerta and wellbutrin and it was over $1400.

F---! And I thought a month's supply of buprenorphine (around $150) was expensive.

> So I left a note for my pdoc (who I see Monday) that he's got to come up with a generic substitute, even if it's short acting;

Yes, there isn't any generic OxyContin, but there is generic immediate-release oxycodone. MS Contin does come in a generic, tho'.

> I can't afford almost $1,800 out of pocket on meds and general insurance every month--my insurance pays 100% of medical bills but no persciption benefits.

Oh, that sucks.

> I wonder if it's worth going down to Mexico.

I don't know. I'd be concerned about legal issues.

> So my drug stuff is all up in the air. The only good news is since going up about a month or longer on the oxy, I haven't had to go up any more. But it's still too early to tell if it's permanent.

Well, I'm crossing my fingers for you.

> Man, on top of dealing with the depression, I can't deal with worrying about money.

I've had to deal with depression and worrying about money at the same time before. I think you'll manage.

Best wishes,
-elizabeth


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