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Re: Morphine for depression » Elizabeth

Posted by shelliR on November 21, 2001, at 9:53:40

In reply to Re: Morphine for depression » shelliR, posted by Elizabeth on November 19, 2001, at 13:02:38

> > I'm sorry, I got so mixed up. It's methodone he's written the prescription for: methadone 10mg tabs; 4 tabs three times daily.
> That's a **lot** of methadone! Then again it might be the right amount, since you do have some tolerance from taking the oxycodone.

Unfortunately, I have a lot of tolerance, which I was not expecting. And although he wrote 3x a day, he told me to take it only twice. So total of 80mg.

I wouldn't mind taking 10-20mg before bed in order to not wake up depressed. I'm not sure why the effects are not lasting longer--it's supposed to be a 24 hour drug. (Of course oxy was supposed to be 12hr and it lasted 8; but this is an even larger discrepency.) I felt a let down (again in my chest) in the early evening--again after about 8 hours.

>
> No, but I bet opioid combinations are often used to control pain for dying patients (cancer, etc.). But methadone binds very tightly to opioid receptors (like buprenorphine, only methadone is a full agonist), and as a result it tends to prevent other opioids from doing anything. (This makes it particularly useful for people with heroin dependence.)

So if I'm ever injured or in great pain, they would have to give me more methadone? Oxy or morphine would not be at all effective while I'm on methadone?
>
>.... I suppose you could rationalize your use of it by saying that depression is just emotional pain (and honestly, I don't think that depressive pain and nociceptive pain are all that different).

My depression absolutely feels like physical pain.
It's like a huge heavy weight pressing on my chest.
I am in therapy, but working on issues that don't feel related to that pain. More about dissociating, not being able to control bad feelings, etc.


It feels almost identical to my oxy dose; there's a tiny bit of high. Yesterday first I took 30mg and didn't feel as good as with my oxy dose, so I added 10mg. The pills are scored so probably should have started at 35mg twice a day. I am hoping to stay at this dose so I didn't want to start at 35 and have to ask my pdoc to raise to 40 so I would feel a little better. I was scared that I felt too good yesterday: (of course it was a beautiful 70 degree day here and I finally taking a break from work to plant bulbs). But at first on oxycontin I felt too high at the lowest dose, and then of course I got too used to them, and had to go up. My measure of how much to take is the pain/pressure in my chest. Its absence is all I am looking for.


When people are on methadone maintenance, do they generally become habituated to their dose and have to raise it (like my experience on oxycontin), or is it a more stable opiate?

I hope you are doing well on your combo.

Shelli


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