Posted by Chuckie on October 31, 2003, at 17:31:12
In reply to Re: elizabeth about dosing on opiates/ anyone » Chuckie, posted by Ame Sans Vie on October 31, 2003, at 14:45:25
> > I'm glad you're finding relief w/Ultram.
> Thanks, but unfortunately I had to discontinue it last week. It was worsening my fibro pain so much that I had trouble ever getting out of bed.<
Yah, that's one the other problems I have with it, I do have legit chronic pain and it doesn't help much. People must react differently to it because I've heard lots of success stories, but I guess that's true of any medication.
My body thinks the most evil drug on Earth is Prozac. Go figure.
> Well, the addiction risk is pretty low, you're right about that, but the withdrawal is insane. It's not opioid withdrawal -- there are none of the typical opioid abstinence symptoms. It feels exactly like Paxil or Luvox withdrawal, which makes me think that its "mild 5-HT/NE reuptake inhibition properties" aren't quite so mild as they think. I started taking Prozac and quit the Ultram that very day -- once I had the 5-HT/NE action of the Prozac in my system, the withdrawal was a piece of cake. The other times I tried to quit I was constantly contemplating suicide.<
Good grief! I hope that doesn't happen to me. I think I can take it or leave it, and I'd rather leave it. But then I've only taken it for a month, so to give it a fair trial.
> That's too bad... one thing I've noticed myself is that lower doses can be more sluggish and tricyclic-feeling (yuck) while dosages of about 400mg/day (which I was taking) are more uplifting and activating. How large was your dose?<
50mg x2, 4 times a day. Somewhere I read, and my Doc said something about it too, that 400mg/day is the most for anyone under any circumstances, after which er... something really bad happens?
> DLPA is a must, though, provided you can take it. the D- isomer of phenylalanine inhibits the enzyme which breaks down endorphins and enkephalins, raising levels of those substances in our brains, and the L-isomer primary goes on to form thyroid hormone, tyrosine, dopamine, norepinephrine, epinephrine and alpha-phenylethylamine. Plain DPA is available if you don't want the stimulating element of LPA. <
Yes, please, refer me to the post, or I'll see if I can turn it up in a search. Cuz I have no idea what you just said there.
> Sure -- this is something that is actually just now catching on in pain clinics. An opioid (usually morphine) is prescribed along with a small dose of naltrexone; the morphine's action isn't inhibited and tolerance build-up is often very much delayed. <
Cool, I'll add that to my information arsenal. Thanks.
> I believe that the antagonists don't actually begin to block binding of exogenous opioid agonists when taken orally except at doses somewhat larger than those used for tolerance prevention. But that raises the question, "how do they work at such low doses then"? I'll have to look into it, lol. <
I think I get it. I've been reading much the same stuff as you, I think, but apparently with less comprehension.
> Also, the dextromethorphan I mentioned would probably be less expensive to use than naltrexone (I have no clue how much naltrexone costs; DXM is OTC at less than $20 for a month's supply. And probably is more effective. A morphine/dextromethorphan product called MorphiDex is being studied now, with good results. <
Well, I'd just as soon stick with good old generic hydrocodone, if I can use antagonists to help prevent 'problems' and make my Doc feel more secure. Anything that has a brand name and/or is being tested, is probably beyond my budget.
> Just curious, do you just see a GP -- not a psychiatrist? <
Long story, but yes. I haven't seen a mental health professional in at least ten years. I saw way too many of them prior to that.
At least my GP listens to me and tries to help, for the most part. I'm just worried about how much help he'll be with this, and I'm worried cuz he's getting old and might retire or die.
Hey, thanks for the info and the moral support. I am so glad to have found this place.