Psycho-Babble Medication Thread 952

Shown: posts 1 to 25 of 32. This is the beginning of the thread.

 

Opioids for depression

Posted by Anonymous on October 25, 1998, at 21:12:49

In Peter Kramer's "Listening to Prozac," he states that "for unknown reasons, rare depressed patients even today will respond to no medicine exept opiates, and a few researchers into depression have become newly interested in these substances" (p. 49). I have been taking various antidepressants off and on for several years. Also, from time to time, I acquire hydrocodone through friends, and "self-medicate." A casual observer would think I was "addicted," but the main criteria of addiction are not met in my case: 1) I never actively seek out the drugs; I am never even persistent in asking potential suppliers for them. They just "fall into my lap," so to speak. And I certainly never engage in criminal behavior to get them. 2) Even after a week or so, I don't experience withdrawal symptoms and am able to go back to my normal state rather easily.

My question is this: what research into opioids-as-antidepressants is being done in the field today? Are opioid narcotics ever prescribed for psychiatric reasons? If they're helpful and cause no real problems, then what's wrong with taking them? I read here once that their effects mimic depression, but that doesn't apply in my case; even though they're "depressants," my spirits are often lifted and I even feel more energy sometimes.

 

Re: Opioids for depression

Posted by LT on October 25, 1998, at 22:34:59

In reply to Opioids for depression, posted by Anonymous on October 25, 1998, at 21:12:49

> In Peter Kramer's "Listening to Prozac," he states that "for unknown reasons, rare depressed patients even today will respond to no medicine exept opiates, and a few researchers into depression have become newly interested in these substances" (p. 49). I have been taking various antidepressants off and on for several years. Also, from time to time, I acquire hydrocodone through friends, and "self-medicate." A casual observer would think I was "addicted," but the main criteria of addiction are not met in my case: 1) I never actively seek out the drugs; I am never even persistent in asking potential suppliers for them. They just "fall into my lap," so to speak. And I certainly never engage in criminal behavior to get them. 2) Even after a week or so, I don't experience withdrawal symptoms and am able to go back to my normal state rather easily.
> My question is this: what research into opioids-as-antidepressants is being done in the field today? Are opioid narcotics ever prescribed for psychiatric reasons? If they're helpful and cause no real problems, then what's wrong with taking them? I read here once that their effects mimic depression, but that doesn't apply in my case; even though they're "depressants," my spirits are often lifted and I even feel more energy sometimes.
Dear Anonymous, I have the same experience. I have been taking darvocet once daily for chronic back pain for about a year and a half, I take 40 mg of prozac in the morning which improves the depression for a couple of hours, then after I am at work for 2 or 3 hours the back pain gets much worse, also the depression. Taking the darvocet gives me about an hour and a half of some pain relief and lifts the depression somewhat. Recently I had a foot injury and my orthopedic dr. said to take vicoprofin instead of darvocet for pain and I get the same results with that. I only take it once daily because I had a psychiatrist tell me it could cause depression, I have not found this to be true in my case, I have had the depression a lot longer than the pain!

 

Re: Opioids for depression

Posted by kore on October 27, 1998, at 21:45:55

In reply to Opioids for depression, posted by Anonymous on October 25, 1998, at 21:12:49

> In Peter Kramer's "Listening to Prozac," he states that "for unknown reasons, rare depressed patients even today will respond to no medicine exept opiates, and a few researchers into depression have become newly interested in these substances" (p. 49). I have been taking various antidepressants off and on for several years. Also, from time to time, I acquire hydrocodone through friends, and "self-medicate." A casual observer would think I was "addicted," but the main criteria of addiction are not met in my case: 1) I never actively seek out the drugs; I am never even persistent in asking potential suppliers for them. They just "fall into my lap," so to speak. And I certainly never engage in criminal behavior to get them. 2) Even after a week or so, I don't experience withdrawal symptoms and am able to go back to my normal state rather easily.
> My question is this: what research into opioids-as-antidepressants is being done in the field today? Are opioid narcotics ever prescribed for psychiatric reasons? If they're helpful and cause no real problems, then what's wrong with taking them? I read here once that their effects mimic depression, but that doesn't apply in my case; even though they're "depressants," my spirits are often lifted and I even feel more energy sometimes.

 

Re: Opioids for depression

Posted by tom on October 28, 1998, at 14:20:22

In reply to Re: Opioids for depression, posted by LT on October 25, 1998, at 22:34:59

> > In Peter Kramer's "Listening to Prozac," he states that "for unknown reasons, rare depressed patients even today will respond to no medicine exept opiates, and a few researchers into depression have become newly interested in these substances" (p. 49). I have been taking various antidepressants off and on for several years. Also, from time to time, I acquire hydrocodone through friends, and "self-medicate." A casual observer would think I was "addicted," but the main criteria of addiction are not met in my case: 1) I never actively seek out the drugs; I am never even persistent in asking potential suppliers for them. They just "fall into my lap," so to speak. And I certainly never engage in criminal behavior to get them. 2) Even after a week or so, I don't experience withdrawal symptoms and am able to go back to my normal state rather easily.
> > My question is this: what research into opioids-as-antidepressants is being done in the field today? Are opioid narcotics ever prescribed for psychiatric reasons? If they're helpful and cause no real problems, then what's wrong with taking them? I read here once that their effects mimic depression, but that doesn't apply in my case; even though they're "depressants," my spirits are often lifted and I even feel more energy sometimes.
>


Dear anonymous, I have had similar succes in taking opiods for deppression/agitation. i had started out taking vicodan, which a friend had suggested might help me, which it did,but after a few months the daily dose that i was consuming had now increased from the one that would suffice months previous,up to 12 or15. at any rate, after 2 years of unsuccessfully trying to self-medicate with morphine,I subsequently ended up on methadone for 3 years,which helped a considerable amount with the depression ect., but it was a pain in the ass to dealing with the methadone programs, and that stuff is hell to get off of, so unless you can get a lifetime supply of lortab,or you want to do the methadone thing, or untill they legalize drugs, I would suggest alternate methods of dealing with depression.

 

Re: Opioids for depression

Posted by kore on October 29, 1998, at 15:49:14

In reply to Re: Opioids for depression, posted by kore on October 27, 1998, at 21:45:55

> > In Peter Kramer's "Listening to Prozac," he states that "for unknown reasons, rare depressed patients even today will respond to no medicine exept opiates, and a few researchers into depression have become newly interested in these substances" (p. 49). I have been taking various antidepressants off and on for several years. Also, from time to time, I acquire hydrocodone through friends, and "self-medicate." A casual observer would think I was "addicted," but the main criteria of addiction are not met in my case: 1) I never actively seek out the drugs; I am never even persistent in asking potential suppliers for them. They just "fall into my lap," so to speak. And I certainly never engage in criminal behavior to get them. 2) Even after a week or so, I don't experience withdrawal symptoms and am able to go back to my normal state rather easily.
> > My question is this: what research into opioids-as-antidepressants is being done in the field today? Are opioid narcotics ever prescribed for psychiatric reasons? If they're helpful and cause no real problems, then what's wrong with taking them? I read here once that their effects mimic depression, but that doesn't apply in my case; even though they're "depressants," my spirits are often lifted and I even feel more energy sometimes.
for a long discussion ,reprint of research artcicle on the use of buprenorphine for depression, etc. go to the site sci.med.pschobiology. don't know how one would actually find a dr. willing to prescribe it though,when even people with "legitimate", i.e. physical pain, can't get enough .

 

Re: Opioids for depression

Posted by k on January 30, 1999, at 13:06:05

In reply to Re: Opioids for depression, posted by kore on October 29, 1998, at 15:49:14

> > > In Peter Kramer's "Listening to Prozac," he states that "for unknown reasons, rare depressed patients even today will respond to no medicine exept opiates, and a few researchers into depression have become newly interested in these substances" (p. 49). I have been taking various antidepressants off and on for several years. Also, from time to time, I acquire hydrocodone through friends, and "self-medicate." A casual observer would think I was "addicted," but the main criteria of addiction are not met in my case: 1) I never actively seek out the drugs; I am never even persistent in asking potential suppliers for them. They just "fall into my lap," so to speak. And I certainly never engage in criminal behavior to get them. 2) Even after a week or so, I don't experience withdrawal symptoms and am able to go back to my normal state rather easily.
> > > My question is this: what research into opioids-as-antidepressants is being done in the field today? Are opioid narcotics ever prescribed for psychiatric reasons? If they're helpful and cause no real problems, then what's wrong with taking them? I read here once that their effects mimic depression, but that doesn't apply in my case; even though they're "depressants," my spirits are often lifted and I even feel more energy sometimes.
> for a long discussion ,reprint of research artcicle on the use of buprenorphine for depression, etc. go to the site sci.med.pschobiology. don't know how one would actually find a dr. willing to prescribe it though,when even people with "legitimate", i.e. physical pain, can't get enough .
***i have battled depression for all my life. i have tried alot of antideppresants to: i am currantly on paxil. last year, however i broke my ankle and was put on vicodan. wow! what a differance, a sense of calm and nirvana passed over me. i got to take it again for foot pain and also when my roomate had a medical injury: both times i loved it. i asked my doctor is he would prescribe it but he would not for deppression. why cant the make prozac that would make you feel like vicodan?

 

Re: Opioids for depression

Posted by Wayne R. on February 8, 1999, at 5:28:46

In reply to Opioids for depression, posted by Anonymous on October 25, 1998, at 21:12:49

See my posting in February "Naltrexone for SSRI poop out". There may be a connection... Wayne

 

Re: Opioids for depression

Posted by thomas1111 on November 16, 2003, at 5:40:07

In reply to Re: Opioids for depression, posted by kore on October 29, 1998, at 15:49:14

just noticed the forum on treating deppression with opioids and was so pleased even ecstatic!..b/c it is a subject i feel very strongly about...i have a lot to say so ill just get started.. i have been clinically diagnosed w/depression/bi-polar disorder/manic depression etc..since about the age of 16,when i saw my first psychologist...i now know i have been suffering with these symptoms all my life..years of therapy did wonders for me. I graduated from many programs and therapy groups, but still seemed to have this chemical thing going on, these way-ups and way-downs associated w/bi-polar, i never hallucinated or any thing like this only suffered from severe deppression for days at a time,followed by many days of grandeur like feelings....anyway, to get to my point, i began to self medicate with alcohol, marijuana, cocain,and ecstacy...or pretty much any thing i could get my hands on , exept for the opioids-they never seemed to agree with my stomache..and i just didnt like the way they made me feel then....then some thing happened i had fallen 26 feet to the concrete and needless to say was pretty messed up for quite a few months-well to make a long story short i came out an addict of pain pills-my girlfrind at the time was a massage therapist who suffered from a lot of these same sympytoms so many of us do..but she was bound and determined to break free from these terrible states of mind through a combination of exersise, positive affirmations, yoga,meditation and occasional marijuana use-basically everything but the heavy drugs...im no longer with her but occasionally we communicate and she still is fighting these same battles with depression and most of the time losing..im not knocking any of these methods im just saying that there not enough for a lot of us...to get back to opiates ididnt realize it for about a year but i was addicted..im a photographer, i went out for 3 months of shooting...the whole time i was more depressed than i have ever been...when i came back i went on a long binge of taking lorecets,vicodens and eventually oxicontin..it was very easy to aquire these drugs b/c i live in new orleans and the amount of pain clinic doctors who write these medicines(mostly lorcet,vicode,oxy.,methadone and xanax and soma)was on the rise here now there everywhere in this city, and so easy to get into that almost any one could get large quantitys of these drugs so easily...when it got to expensive for me i went to the doctors and stayed on a roller coaster for years eventually ending up on the methadone clinic where ive been now for 7 months......this is the most important thing i want to say...i have not been depressed since i got on the methadone clinic--i dont want to be back to that state of deppresion again...i feel great now--no anti-deppressant did that for me...why is sit that the drugs like prozac and zoloft are so readily prescribed for these symptoms sooo many of us have...im not getting off methadone any time that i can see in the future--its a small price yto pay to not feel those sad even sometimes suicidal feelings again...why arent doctors prescribing it for us--because its addicting--well it sucks being addicted but now that im getting it from adoctor that i only have to see once a month and not go somewhere everyday or 3 days a week to get the methadone....its my happy pill and its a small price to pay to not be depressed anymore...this is my opinion does anyone feel theway i do...id like to hear from doctors @ what they feel @ the tradeoff.....thomas

 

Re: Opioids for depression » Anonymous

Posted by Flipsactown on November 17, 2003, at 23:01:52

In reply to Opioids for depression, posted by Anonymous on October 25, 1998, at 21:12:49

I wished that opiods do relieve depression, but in my case, it has not. I have been clinically depressed for 12 years primarily caused by my chronic back pain suffered in a traffic accident. I have been on tylenol/codeine for about 10 years until I finally insisted to be prescribed oxycontin. My GP doctor referred me to a pain doctor who at first would not prescribe oxy to me, I guess partly because of all the bad press. Anyway, he was ok with prescribing oramorph which is generic ms-contin also an opiod. Well I got very sick to my stomach, nausea, vomit, etc., within a couple of days. So the pain doc finally decides to prescribe oxy. I have been on oxy the past 2 years. Although it helps with the chronic pain, it does not act as an antidepressant and could possibly be exacerbating my depression says my pdoc. I am caught between a rock and a hard place. I need oxy for pain and I need several antidepressants for depression. I am currently on prozac, remeron and lamictal. Lamictal was added 7weeks ago and has had a dramatic lifting of my depression. Bottomline, at least in my case, opiods per say, is not an antidepressant.

Flipsactown

> In Peter Kramer's "Listening to Prozac," he states that "for unknown reasons, rare depressed patients even today will respond to no medicine exept opiates, and a few researchers into depression have become newly interested in these substances" (p. 49). I have been taking various antidepressants off and on for several years. Also, from time to time, I acquire hydrocodone through friends, and "self-medicate." A casual observer would think I was "addicted," but the main criteria of addiction are not met in my case: 1) I never actively seek out the drugs; I am never even persistent in asking potential suppliers for them. They just "fall into my lap," so to speak. And I certainly never engage in criminal behavior to get them. 2) Even after a week or so, I don't experience withdrawal symptoms and am able to go back to my normal state rather easily.
>
> My question is this: what research into opioids-as-antidepressants is being done in the field today? Are opioid narcotics ever prescribed for psychiatric reasons? If they're helpful and cause no real problems, then what's wrong with taking them? I read here once that their effects mimic depression, but that doesn't apply in my case; even though they're "depressants," my spirits are often lifted and I even feel more energy sometimes.
>

 

Re: Opioids for depression

Posted by maxx44 on November 20, 2003, at 17:34:10

In reply to Re: Opioids for depression, posted by thomas1111 on November 16, 2003, at 5:40:07

interesting---i'm an 'accidental benzo addict', and the cost of the emotional dulling has driven me to solitude. recently i was marooned with a relative who just had a pacemaker put in. it became infected and things led to my running out of librium. i figured i'd 'tough-it-out' for the few days before a texas relative could arrive and take over monitoring her. i went into withdrawal. she really didn't understand(does anyone inexperienced)? but she had a bottle of vicodin and suggested i try it. it knocked the benzo withdrawal cold. i also noticed less depression and greater motor activity. my dr., not the one that got me nailed, had told me after 10 years of xanax and librium i was looking at a year's taper down probably followed by protracted withdrawal symptoms, and as i'm near 60, he felt i was better off staying on librium. but now i wonder. my dr. had mentioned detox from opiates was much easier than from long-term benzo use. i only used vicodin for days, so i don't know if it would maintain the lack of benzo withdrawal. oddly, i know several ex xanax addicts that 'got away' by switching to tylenol-3 or vicodin. i realize i am not they, but their level of function far exceeds mine---anyone with input on this? on librium i don't miss my children, cry, feel joy, etc. i have other problems from meds as a bipolar, but that's another story. thanks

 

Re: Opioids for depression

Posted by YoYoMe on December 6, 2003, at 0:45:25

In reply to Re: Opioids for depression, posted by thomas1111 on November 16, 2003, at 5:40:07

I have BP disorder. For me, opioids definitely do alleviate depression. But they've received such bad press because of their abuse potential, that getting them studied and approved for our use is sure to be a long way off. It may never happen, unless drug companies can find a way to eliminate the risky side effects, that is, habituation, or, worse, the dreaded euphoria.

 

Re: Opioids for depression

Posted by maxx44 on December 6, 2003, at 1:58:49

In reply to Re: Opioids for depression, posted by YoYoMe on December 6, 2003, at 0:45:25

stevie nicks (fleetwood mac) was addicted to klopin for 8 years, and really pissed (it's online) seeing heroin users out in a week---while she's kept 47 days for the benzo. 10 years for me. a year's taper, with probable 'protracted withdrawal syndrome' till dead. as opiate addiction is considered a cake-walk to a decade of daily benzos,(sweden pays to 8 month's benzo detox hospitalization), i'm looking for any data on opiate use replacing a year's benzo taper -characterized by panic and terror. see my point?

 

Re: Opioids for depression

Posted by Burnedout on December 6, 2003, at 14:55:13

In reply to Re: Opioids for depression, posted by maxx44 on December 6, 2003, at 1:58:49

My depression is deep and of the melancholia type.

I took an anti-depressant that instead of helping, put me in the ER for 8 hours, with having 3 CT scans, plus all kinds of blood work.

The pain I was having was very real. They filled me up with Toradol and I was still in trouble. Finally, things subsided enough, that I could go home. And the hospital sent me home with a few percoset.

I've had percoset before for pain, but at that time I wasn't depressed.

This time, it was amazing when I took it. Thirty minutes after, I felt like a normal human being--there was no high, no nothing, other than "this is the way I used to feel."

I couldn't believe it. Of course, the affect soon wore off--gone in two - four hours. But it was a definite--yes. Opioids helped the depression.

My therapist suggested a simple answer (which I don't think I go for, but it may be true). Since this affect happens only rarely and usually in people who have tried, unsuccessfully, everthing else, maybe our minds are structured a bit differently.

His answer was that it kind-of-makes-sense.
When you are depressed, you are feeling emotional pain.
When you are hurt physically, you are feeling physical pain.
Pain, is perceived in the brain.

Maybe there is something about our brains that doesn't distinguish between physical and emotional pain. That would explain why pain medicine works for us in relieving the "pain" of depression.

Maybe we don't need the serotonin, etc., maybe it's something else.

My psychatrist said he's run into this before, too. But only with the people who have refractory depression.

He said he wished he could prescribe the pain med for depression (I suppose he could) but he'd get into a lot of trouble.

Wouldn't this make an interesting clinical study?
I wonder what an MRI scan would show?

All I know for certain was that I was suddenly out of the depression, I wasn't high, I could talk to my family, I could do things in a normal way. It was a miracle. How wonderful it was to be "normal" for those 4 hours.

So, I'll vote "yes" for Opioids as being used to relieve depression in certain cases.

I'm ready to join a clinical study on it. What about you?

 

Re: Opioids for depression

Posted by YoYoMe on December 6, 2003, at 16:04:34

In reply to Re: Opioids for depression, posted by Burnedout on December 6, 2003, at 14:55:13

>"...I'll vote "yes" for Opioids as being used to relieve depression in certain cases.
>
> I'm ready to join a clinical study on it. What about you?"

Yes, and Yes.
Makes perfect sense to me. My own experience (not high, but blessedly normal) has been EXACTLY like yours. My psychiatrist was less conversational on the subject, but then he never does say much. He did say that the possibility was being studied, but not by very many people. He said that if I wanted to follow the research (and didn't mind wading through technical medical jargon) I could try www.pubmed.com, searching on "opioid receptors and depression." I did, and sure enough, it was all rats and chemistry. From what I could glean, they're looking for a more selective opioid chemical, one that won't cause the dreaded euphoria. The fact that you and I don't get euphoric or addicted isn't enough to quell doctors' lawsuit jitters, as you suggested. So yes, I'll sign up for any study that comes along. I'll also sign anyone's petition to light a fire of reform under the ice-chilly fear that malpractice litigation instills, preventing medical breakthroughs from happening, and informed consenting grown people from acting in their own best interests. First, we'll have to sedate all the lawyers.

 

Re: Opioids for depression

Posted by maxx44 on December 6, 2003, at 20:01:55

In reply to Re: Opioids for depression, posted by Burnedout on December 6, 2003, at 14:55:13

well, 'refractory-depression's' my middle name. i think it related to 10 year's of benzos. i ran out, but before full withdrawal hit (er deal), a relative handed me some 'pain' pill--withdrawal stopped. i'd never heard of anything that could stop long-term benzo withdrawal, save perhaps neuroleptics, i can't use them, fortunately?, and i know opiate withdrawal is hell. but benzos also are. so i went looking and found this board. more money in risperdal/zyprexa than old cheap opiates--i doubt that would interest money-driven drug co. studies. a university? depends. it's certainly a 'lessor of evils' deal. best wishes

 

Re: Opioids for depression

Posted by bsj on December 6, 2003, at 20:55:42

In reply to Re: Opioids for depression, posted by kore on October 27, 1998, at 21:45:55

"I read here once that their effects mimic depression, but that doesn't apply in my case; even though they're "depressants," my spirits are often lifted and I even feel more energy sometimes."

The classification of opiates as "depressants" is based on their effects on heart rate and breathing. This DOES NOT mean nor imply that they induce a depression-like state; on the contrary, taken in sufficient doses they feel great. It's easy to confuse these ideas, and think that depressant=induces depressed-like state. But no.

Depression, the illness, is likely caused by malfunction of our basic brain system; one of these systems being the innate opiod system. It can either produce too much or too little amount of endorphins; in the former case, we get those amazing people who can take vast amounts of physical pain; and in the latter case, we'd get depression-like symptoms.

I've explained this several times in various places before.

 

Re: Opioids for depression

Posted by bsj on December 6, 2003, at 21:01:55

In reply to Re: Opioids for depression, posted by YoYoMe on December 6, 2003, at 16:04:34

"He did say that the possibility was being studied..."

That, unfortunately, is the psychiatrist's mantra: LET'S STUDY IT. Studies be damned! There are people who need help RIGHT NOW!

For refractory cases who respond well to opiates, there are ways of keeping yourself medicated. See my thread "Discussion of Opiate Therapy" in the Substance forum.

 

Re: Opioids for depression

Posted by bsj on December 6, 2003, at 21:08:27

In reply to Re: Opioids for depression, posted by Burnedout on December 6, 2003, at 14:55:13

"Maybe there is something about our brains that doesn't distinguish between physical and emotional pain. That would explain why pain medicine works for us in relieving the "pain" of depression."

There is no distinction between mental and physical pain; the traditional Cartesian mind-body distinction doesn't hold (you'd think that scientists, of all people, would give up this silly mental vs. physical dichotomy). Mental pain is the same suffering as physical pain, but without the localized sensation of pain. Next time you're physically hurting and take an opiate, study closely what happens: the pain doesn't suddenly vanish; you can still sense it there, but the suffering is gone. It's not causing you to suffer anymore. Opiates don't diminish localized sensations of pain; rather, they diminish suffering, whether there's a localized sensation of pain or not.

 

Re: Opioids for depression

Posted by Viridis on December 7, 2003, at 1:32:52

In reply to Re: Opioids for depression, posted by bsj on December 6, 2003, at 21:08:27

I've been very impressed with the effects of hydrocodone (the opioid in Vicodin, Vicoprofen, etc.) on my mood. I've had some recurring problems with a tooth over the last couple of years and have been prescribed a fair bit of Vicoprofen, which I've used completely legitimately and responsibly on a very sporadic basis. Invariably, my mood improves (and stays that way) for two or three days after taking a therapeutic dose.

I'm not talking about euphoria etc., just greater enthusiasm and energy. And no, I haven't abused these meds at all, just used them here and there as prescribed. I'm thinking about how to broach this with my pdoc -- he's a very open-minded person and I expect will agree with my conclusions, yet he's also quite frank about what meds he can and cannot prescribe safely (from a legal perspective).

The frustrating thing is that opioids are very safe when taken properly, and even if one does become dependent the health risks appear to be low. They have a long history of use in medicine but, much like benzodiazepines, now have a stigma attached to them, plus there's little money to be made (the latter two points are not unrelated to one another).

I'm all for new developments in psychiatric drugs, but wish that there were some incentive for doctors and pharmaceutical companies to re-explore some of these older meds as well. It seems that once a new class of drugs gains patent status, the older, now-generic ones become taboo whether they're really inferior or not.

 

Re: Opioids for depression

Posted by bsj on December 7, 2003, at 2:33:12

In reply to Re: Opioids for depression, posted by Viridis on December 7, 2003, at 1:32:52

"I'm thinking about how to broach this with my pdoc -- he's a very open-minded person and I expect will agree with my conclusions, yet he's also quite frank about what meds he can and cannot prescribe safely (from a legal perspective)."

It'll likely be a waste of your time. Even if a psychiatrist was willing to give you hydro for mood-improvement (and they all seem to be against this), if he did, the DEA would be down on him in no time. Opiates are not approved for psychiatric use. The DEA makes the medical decisions in this country, because doctors and the AMA lack testicles.

"The frustrating thing is that opioids are very safe when taken properly, and even if one does become dependent the health risks appear to be low."

Taken in reasonable doses, opiates are some of the safest drugs in the world. They've been with us for 200+ years, and we know all their longterm health effects; which are negligible (e.g., William Burroughs came off a lifetime of shooting street heroin with only a slightly weakened liver--and that could have been caused by his frequent drinking or adulterants in the heroin). The stigma against opiates is political, and can be traced back to the late 19th and early 20th centuries, when they were profoundly overused. Modern opiophobia is a knee-jerk reaction to this in the medical community; doctors have fallen pray to the fear just like ordinary people.

"...plus there's little money to be made"

Bingo. A monthly supply of hydro goes for about $25; a monthly supply of Wellbutrin or some other patent medicine for hundreds of dollars per month. Drug companies relentlessly peddle their cheap, third-grade psychotropics to the medical community. But many of these drugs later turn out to be unsafe or have unforeseen side-effects.

"I'm all for new developments in psychiatric drugs, but wish that there were some incentive for doctors and pharmaceutical companies to re-explore some of these older meds as well. It seems that once a new class of drugs gains patent status, the older, now-generic ones become taboo whether they're really inferior or not."

It's all about the Benjamins, and we suffer for it. I'd actually like to see a state-run medical industry in the U.S.; it works great in Europe and Canada. That would cut the profit motive.

 

Re: Opioids for depression » maxx44

Posted by btnd on December 7, 2003, at 8:05:19

In reply to Re: Opioids for depression, posted by maxx44 on December 6, 2003, at 20:01:55

> well, 'refractory-depression's' my middle name.

I've seen studies where Tramadol (Ultram) - unique opiate agonist/antagonist and Buprenorphine - normal opiate agonist - used for refractory and treatment-resistant depression.
I've personally used Ultram before for my melancholic/dysthymic type of depression with success. Now, I've switched to dopaminergic Amisulpride. Just my 2 cents.

 

Re: Opioids for depression » bsj

Posted by btnd on December 7, 2003, at 8:09:04

In reply to Re: Opioids for depression, posted by bsj on December 7, 2003, at 2:33:12

> It'll likely be a waste of your time. Even if a psychiatrist was willing to give you hydro for mood-improvement (and they all seem to be against this), if he did, the DEA would be down on him in no time. Opiates are not approved for psychiatric use. The DEA makes the medical decisions in this country, because doctors and the AMA lack testicles.


Opiates/Opioids are maybe not OFFICIALLY approved, but there are fairly new (1999-2003) studies on Buprenorphine and Tramadol used for depression. And from what I've read, Buprenorphine is a normal (like Hydrocodone/Oxycodone) opiate agonist, used sublingually. You might try printing out the studies and showing them to your pdoc. I'd do that if I were in your shoes ;-)
Take care

 

Re: Opioids for depression

Posted by bsj on December 7, 2003, at 11:24:39

In reply to Re: Opioids for depression » maxx44, posted by btnd on December 7, 2003, at 8:05:19

Buprenorphine is just a partial mu agonist and a kappa antagonist; similar to Ultram. And it's usually combined with naloxone, a mu receptor antagonist. This is done so that addicts don't feel withdrawal but also can't get any of the psychotropic effects of the opiate. I don't know how useful that would be for depression. Ultram did nothing for me.

I'm afraid that the only good opiate antidepressant will have to be a full mu and kappa agonist. Anything less will be a joke. We can't go clamping down on its effects out of a concern for abuse potiental, or we'll undercut it, because the psychotropic effects are exactly what's needed. It would be nice to see an opiate-based drug that's long-acting and manages to raise the concentrations of endophins in vivo, or at least replace tham; that would work. But it would still have some abuse poteintial, by necessity. I'd like to have a drug I could take once a day; as it is now, I take a dose c. every 4 hours.

 

Re: Opioids for depression

Posted by bsj on December 7, 2003, at 11:35:00

In reply to Re: Opioids for depression » bsj, posted by btnd on December 7, 2003, at 8:09:04

Addendum:

I'm finished with psychiatrists; I'm tired of their arrogance, their false promises and their lies. I won't let them hold the keys to my destiny. Self-medication is nowhere near as dangerous as psychiatrists would lead you to believe, if you have the necessary background for it; which I do. They discourage self-medication because (1) most people have no experience with neuropharmacology and (2) it cuts in on their profits. They're like mechanics--naturally they'd discourage you from fixing your own car.

 

Re: Opioids for depression

Posted by maxx44 on December 7, 2003, at 18:25:16

In reply to Re: Opioids for depression, posted by bsj on December 7, 2003, at 2:33:12

your comment on 'organ-damage' is well known. my neighbor in san diego was the chief coroner's aide. she remarked on this. she said when doing autopsies on opiate overdose deaths, she was always amazed at the 'superb' condition of all internal organs. my interest had not included that aspect. the burden of long-term benzo or AD use, as booze, falls on the liver. so your mention of mr. 'naked-lunch's' liver health increases my interest, as i think back on a coroner's observations. i'm simply looking for a way out from previous benzo taper, only to be clobbered Month's later. i don't wish to be a junkie on smack---but as stevie nicks pointed out, 'the hroin people' were out fast---she was held for 47 days, after 8 years of klonopin---and i'm confident those 47 days, did not free her---you find that benzo deal later---out-of-the-blue--why i consider them second only to neuroleptics, as 'toxic-meds'. thanks for that data---regards


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