Posted by SLS on June 18, 2006, at 8:35:31
In reply to Re: Cymbalta withdrawal, posted by Avalon on June 18, 2006, at 1:01:23
> Scott, I need a lesson here: What's an opioid v. a narcotic? I understand Ultram is non-narcotic, but I thought opioids were narcotics...? Also, what is an SRI? I am already taking Percocet (is that an SRI?) and it doesn't help much with the withdrawal symptoms. Thanks for your help.
Hi Avalon.
I have to plead ignorance on this one. The term "narcotic" seems to have various definitions, including those that are dictated by drug enforcement agencies.
From Dictionary.com:"An addictive drug, such as opium, that reduces pain, alters mood and behavior, and usually induces sleep or stupor. Natural and synthetic narcotics are used in medicine to control pain."
"A drug derived from opium or opium like compounds, with potent analgesic effects associated with significant alteration of mood and behavior, and with the potential for dependence and tolerance following repeated administration."
Doctors don't like to use the word "narcotic" because it has become a pejorative in many contexts. They prefer to distinguish them by their chemical class or target receptor - opioids.
SRI = serotonin reuptake inhibitor
SSRI = selective serotonin reuptake inhibitor
SNRI = serotonin-norepinephrine reuptake inhibitor
Drugs like Effexor and Cymbalta are both potent serotonin reuptake inhibitors (SRI), but they are not selective. They also inhibit the reuptake of norepephrine. Thus, they have been given the acronym SNRI.
Ultram (tramadol) is chemically related to Effexor, and possesses some SRI properties. I don't know how they compare with respect to relative potency. Ultram is considered to be an opioid because it acts to stimulate opioid receptors in the brain. Perhaps the reason why it is not considered to be a narcotic is because it is not derived from opium. Because Ultram is a SRI, I would be interested to know whether or not it can help with withdrawal symptoms.
Percocet is a drug preparation that combines oxycodone with acetaminophen (Tylenol). Oxycodone is a more potent opioid than Ultram, but does not possess any SRI properties. I wouldn't expect it to ease withdrawal symptoms.
Are you supposed to switch drugs or are you to add the Ultram to the Percocet?
I don't blame you for wanting to avoid drugs altogether. I feel the same way.
Did your pain lessen while you were on Cymbalta?
- Scott
poster:SLS
thread:466069
URL: http://www.dr-bob.org/babble/wdrawl/20060602/msgs/658252.html