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Re: problems getting buprenorphine » BarbaraCat

Posted by Elizabeth on January 22, 2002, at 18:37:31

In reply to Re: problems getting buprenorphine » Elizabeth, posted by BarbaraCat on January 18, 2002, at 11:54:44

Hi Barbara.

> I've checked past posts, but couldn't find any details on why you've found bu-orphine helpful and what your regimen is. Could you give some info as to what it's treating, results, etc? Is it an opiod, or an antagonist?

Buprenorphine is an opioid mixed agonist/antagonist. It's a partial agonist at the mu receptor (i.e., it activates the receptor, but less than a full agonist such as morphine would) and an antagonist at the kappa receptor. Like the full mu agonists, it's a controlled substance in the U.S., but unlike them, it's only Schedule V (minimal abuse potential). It's used in many countries for maintenance treatment of opioid dependence.

I take 1 mL (= 0.3 mg) three times a day, in addition to 900 mg/day of Trileptal and 187.5 mg/day of Effexor XR (target dose of Effexor is 300 mg/day). I also take Xanax as needed. I have unipolar depression and a possible seizure disorder (hence the Trileptal).

Buprenorphine helps with my mood, energy level, concentration, motivation, optimism, anxiety (including social anxiety), and anhedonia. The Effexor seems to be helping too; I think it is a good combination.

> Also, if you could also answer a burning question - why do opiods have such an energizing effect, at least they do for me.

I don't have an answer for that (they're activating for me, too), and I'm not sure anyone does. In general, opioids have mixed activating and sedating effects (they're not strictly inhibitory or excitatory), to varying degrees for different people. I could speculate about the neurochemical reasons for the variation, but it would just be speculation.

> I've always heard of their sophorific effects, not the calm yet speedy one I get.

"Calm yet speedy" -- that's exactly it. :-)

-elizabeth

p.s. You mentioned that you were recently diagnosed with Bipolar II disorder. There seems to be an epidemic of previously undiagnosed Bipolar II -- everybody is bipolar these days! Do you think the diagnosis is accurate in your case? (Just curious, no relevance to the discussion.)


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