Posted by pseudoname on July 7, 2006, at 14:10:32
In reply to buprenorphine and cognition, posted by pseudoname on June 15, 2006, at 13:09:03
I've found that after being at 0.25 mg/day of buprenorphine (Subutex®) for depression for a couple days, I can take 0.12 mg/day for a couple days without any loss of clinical benefit. But if I start fresh after a holiday at 0.12 mg, it's not enough.
Also, the 0.12 mg seems to wear off noticeably about 9 hours later, and I can wake the next morning with that familiar horror-level depression. It can be a struggle then even to put the bupe in my mouth from my bedside table.
I don't notice any withdrawal symptoms, however, when going to 0.12, even 8 hours after the clinical effect has worn off. Interesting.
The cognitive dopiness that crept on me at my previous higher doses seems to come back a little if I continue for several days at 0.25, but I still haven't tested it with chess games.
I continue to have broader ranges of emotion at these lower doses, including things like compassion, interest, and sadness, that were absent when I was in untreated depression and less pronounced when I was at 1-3 mg/day. I recover very quickly now from being annoyed and without having to suppress lingering bile. I also notice a difficult-to-describe sort of "self-satisfaction" — not (I hope) in a heartless, narcissistic sense, but as an "Oh-yeah-this-is-me" recognition. You are who you are, which is not an idea I could embrace when depressed and wasn't so much aware of when I was at the higher doses.
I have a few remaining pretty serious behavioral problems, mostly neurotic interpersonal fears and avoiding situations like those in which I was abusively frustrated as a child. Those seem unaffected by the opioid, except that I'm much more objectively aware of them now. I'm tackling them by myself with a variety of therapy techniques. I've had only incremental success so far, but that's still some improvement, and I'm pretty happy and hopeful about my prospects.
(To recap, I've gone from 3 mg/day of buprenorphine in January, to 1 in March, to 0.5 and then 0.2 last month. Now between 0.25 and 0.1 mg/day.)
[Buprenorphine for depression links at http://health.groups.yahoo.com/group/psycho-babble-tips/links/buprenorphine_for_de_001146748536/ ]
poster:pseudoname
thread:657263
URL: http://www.dr-bob.org/babble/20060701/msgs/664911.html