Posted by Jackd on November 15, 2005, at 12:18:02
In reply to Re: Tricyclics and anhedonia, posted by neuroman on November 8, 2005, at 10:24:48
Hey, just read your post and I know I'm kinda jumping in the middle of all this, but I just wanted to add that NMDA receptor antagonists have been shown to prevent/reverse opiate tolerance.
Theoretically they have a wide range of therapeutic uses, and I personally take 60mg of Namenda a day (along with Remeron + Effexor, to great effect).
From what I remember anti-depressants all ultimately affect NMDA receptors to some degree, and NMDA antagonists have possible uses for anhedonia (suggesting a link with dopamine?)among other things (neuropathic pain, possibly depression). This makes sense since dopamine/opiate tolerance has a definite dynamic with NMDA receptors, although I'm pretty sure it's not merely a direct antagonist effect.
By the way when I speak of NMDA antagonists I only mean Namenda (Memantine HCl) as it is a non-competitive, safe NMDA antagonist (the rest are neurotoxic and not clinically in use of course; well except ketamine which is used by Veterinarians I think) if they're considering opiates for depression.
Also people mentioned that Effexor has opiate properties/similarities. It does, and yes Ultram is molecularly identical except for its orientation. Effexor, amitryptiline, and Remeron have been shown to exhibit anticociceptive properties, and are sometimes even prescribed specifically for pain. I personally don't experience any back pain when I'm on Remeron + Effexor.
Good luck finding the right doctor in "your quest"; I too had a similar quest and it was only with lots of homework and coaxing that I was able to get on the combo I'm on now.
Just my two cents.
poster:Jackd
thread:575925
URL: http://www.dr-bob.org/babble/20051112/msgs/578956.html