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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by okydoky on July 23, 2008, at 11:31:10
I have been asking a lot from this board.
I have gone off the Oxycontin I was taking for several years and started Avinza (morphine). For the first week or so I felt much calmer and a bit more motivated. I stopped taking any klonopin or perphenazine. I also stopped taking benadryl with valium and klonopin and valerian root (anything around essentially) all day in attempts to sleep constantly. I cannot start Parnate as one planned option to try if I stay on morphine and it seems like the calming and antidepressant effects seem to be wearing off although the pain management is still better. I have started to feel a total panic in my gut which is the norm for me. I was going to try Subutex with Amineptine. What about morphine with amineptine? I do not think from previous posts to me that it has potential better than with oxycontin? I guess the question is should I stay on the morphine and try to address the trd? It was not in my plans and I am unsure how to proceed.
Posted by Phillipa on July 23, 2008, at 12:14:45
In reply to Where to go with Morphine?, posted by okydoky on July 23, 2008, at 11:31:10
Hi Oky I'm sorry you had to increase pain medication. What meds does your doc think would help? No response to depression from opiods? Love Phillipa
Posted by dbc on July 23, 2008, at 12:31:42
In reply to Re: Where to go with Morphine? » okydoky, posted by Phillipa on July 23, 2008, at 12:14:45
i know some people who have been on opiates for pain management find methadone just as useful.
Well im not sure if im supposed to say this on here but since you're discussing opiates openly. Some people augement pain management by making poppy tea with papavar pods (highly available as a "crafting" material on ebay). This is simply a loop hole in a law in the US. Beware of scammers, "The Transplants" is a reliable guy. (this isnt an advertisement i just dont want someone to get ripped off)
In canada the pods are totally legal.
Posted by dbc on July 23, 2008, at 12:37:22
In reply to Re: Where to go with Morphine?, posted by dbc on July 23, 2008, at 12:31:42
To add to my previous post, the pod tea isnt to be taken lightly as the pods contain multiple opiate alkaloids such as morphine, codeine, etc. Its just as dangerous as any other opiate.
Posted by Marty on July 23, 2008, at 12:48:00
In reply to Re: Where to go with Morphine? » okydoky, posted by Phillipa on July 23, 2008, at 12:14:45
Morphine upregulate D2 receptors and sensitize the dopamine system. Amineptine is dopaminergic. One could modulate the effect of the other and vice-versa. I guess it would be way more dopaminergic in its effect when combine.Just my 2 cents. Some on this forum may be well more suited than me to extrapolate on that since I don't have no experience/knowledge regarding opiates.
/\/\arty
Posted by okydoky on July 23, 2008, at 13:14:08
In reply to Re: Where to go with Morphine?, posted by dbc on July 23, 2008, at 12:31:42
Another doc precribed methadone and some on here and my pcp and pian precribing doc said it was a bad idea. Is the augmentation jus tto make the pian med stronger?
Posted by okydoky on July 23, 2008, at 13:24:00
In reply to Re: Where to go with Morphine? » Phillipa, posted by Marty on July 23, 2008, at 12:48:00
Thanks. Here is the original thread where it is theorized that subutex might work better with amineptine than oxycontin. Now as I said that I started down this road I cannot try Parnate which worked long ago and I was hoping might work again nor form this does it appear that the amineptine would be more effective than on oxycontin.
I was feelings so hopefull for almost two weeks on the morphine and now I've got almost all the anxiety back.
Posted by dbc on July 23, 2008, at 13:31:08
In reply to Re: Where to go with Morphine?, posted by okydoky on July 23, 2008, at 13:14:08
> Another doc precribed methadone and some on here and my pcp and pian precribing doc said it was a bad idea. Is the augmentation jus tto make the pian med stronger?
Some people totally replace their pain meds with the tea. The larger the pods its thought the more alkaloids they contain (jumbo 7' 8' 9') being very potent. I would have to agree but also how finely you grind the pods greatly effects their potency.
Posted by Quintal on July 23, 2008, at 15:05:23
In reply to Re: Where to go with Morphine?, posted by okydoky on July 23, 2008, at 13:24:00
>Now as I said that I started down this road I cannot try Parnate which worked long ago...
Why is that? Because you're taking opiates?
Q
Posted by okydoky on July 23, 2008, at 18:17:51
In reply to Re: Where to go with Morphine? » okydoky, posted by Quintal on July 23, 2008, at 15:05:23
I looked into this a while ago and determined that I could take it with oxycontin. A couple of weeks ago I looked again and found I could not take it with morphine and I knew about Demerol which is what motivated me to check again. Now I did a quick search and can only find that neither is ok. I remember asking my pharmacist about the oxycontin to be sure about what I had read.
Do you have any information? How are you doing on the Parnate and how long have you been taking it now? It stopped working for me years ago and I have tried it since with no luck. It has been several years now so I wanted to try it again. It was the only AD that ever worked for me extremely well for several years.
Posted by okydoky on July 23, 2008, at 18:24:21
In reply to Re: Where to go with Morphine? » okydoky, posted by Quintal on July 23, 2008, at 15:05:23
Here is a site that might explain some of the confusion. So some sites are telling me outright I cannot mix the two and others say nothing:
http://www.healthyontario.com/DrugDetails.aspx?brand_id=457&brand_name=Parnate
Posted by Quintal on July 24, 2008, at 7:18:49
In reply to Re: Where to go with Morphine?, posted by okydoky on July 23, 2008, at 18:17:51
That's why I asked, most sources have a blanket statement saying all opiates are contraindicated with MAOIs, but this isn't true - only a few select ones are, and that's because they happen to have additional serotonin reuptake activity and this carries the risk of serotonin syndrome. Pethidine, tramadol and dextromethorphan are the main culprits if I remember rightly. Morphine, oxycontin, codeine, buprenorphie and methadone are okay, but most patient resorces will state otherwise. I remember my pdoc saying when I started Parnate "If you get run over by a bus there will be nothing we can give you" (!).
The pharmacologist Ken Gillman has published some excellent advice on MAOI-opiate interactions:
http://www.psychotropical.com/8_st_maois_opiate_analgesics.shtmlA few posters on babble have combined buprenorphine and codeine with Parnate in the past, so you might want to check the archives. I think Elizabeth was one of the most prominent.
Q
Posted by yxibow on July 29, 2008, at 1:30:38
In reply to Re: Where to go with Morphine?, posted by dbc on July 23, 2008, at 12:37:22
> To add to my previous post, the pod tea isnt to be taken lightly as the pods contain multiple opiate alkaloids such as morphine, codeine, etc. Its just as dangerous as any other opiate.
Yes. Shall I say I have grown it for its backyard colour -- which is fascinating on some varieties, and perfectly legal still, but I wouldn't really touch the stuff without knowing what to do with it properly. People have died from making a concoction with the seeds.
Posted by yxibow on July 29, 2008, at 1:47:00
In reply to Where to go with Morphine?, posted by okydoky on July 23, 2008, at 11:31:10
> I have been asking a lot from this board.
>
> I have gone off the Oxycontin I was taking for several years and started Avinza (morphine). For the first week or so I felt much calmer and a bit more motivated. I stopped taking any klonopin or perphenazine. I also stopped taking benadryl with valium and klonopin and valerian root (anything around essentially) all day in attempts to sleep constantly.Is this an attempt to avoid life as we know it? I don't wish to be ad-hominem but if there is this history in your profile, I'm not quite sure how you got onto opiates in the first place. It does ring a little bit of addiction, or at least avoidance of life, which although may feel good, well --- it isn't really a "cure" for depression, since avoidance is one quality. Just a thought.
I cannot start Parnate as one planned option to try if I stay on morphine and it seems like the calming and antidepressant effects seem to be wearing off although the pain management is still better. I have started to feel a total panic in my gut which is the norm for me. I was going to try Subutex with Amineptine. What about morphine with amineptine? I do not think from previous posts to me that it has potential better than with oxycontin? I guess the question is should I stay on the morphine and try to address the trd? It was not in my plans and I am unsure how to proceed.
Best be careful with morphine -- it is primarily used for palleative care (end of life or major trauma). At some point there is no point of return without heroic effort, [usually though on IV drips.]
It's not surprising the honeymoon with morphine has ended. Opiods generally give the giggles for a few weeks for their intended use and gradually become very potent drugs that require withdrawal.I can see where the possibility that it has helped the removal of perphenazine as u-receptors have been explored in schizophrenia.
Bupenorphine and amineptine together seem to be two addictive agents combined. I don't know what would occur when that happens. Best to have a psychiatrist (I hope you do) that is specialized in addiction medication.
Posted by Quintal on July 29, 2008, at 9:02:03
In reply to Re: Where to go with Morphine? » okydoky, posted by yxibow on July 29, 2008, at 1:47:00
>Is this an attempt to avoid life as we know it? I don't wish to be ad-hominem but if there is this history in your profile, I'm not quite sure how you got onto opiates in the first place. It does ring a little bit of addiction, or at least avoidance of life, which although may feel good, well --- it isn't really a "cure" for depression, since avoidance is one quality. Just a thought.
Let's not jumpt to conclusions here. Oky has said in the past that she is being treated by a pain specialist, I suppose for some sort of chronic pain condition. She isn't addicted to street drugs and she isn't taking opiates without a prescription or medical supervision.
>Best be careful with morphine -- it is primarily used for palleative care (end of life or major trauma). At some point there is no point of return without heroic effort, [usually though on IV drips.]
I don't know what on Earth you mean here. I would think the pain specialist, or indeed any doctor would be aware of all the potential pitfalls of morphine. He must have reason to believe it's the best option in Oky's particular set of circumstances.
Q
Posted by okydoky on July 29, 2008, at 11:34:27
In reply to Re: Where to go with Morphine? » okydoky, posted by yxibow on July 29, 2008, at 1:47:00
It's okay. I am not insulted; you do not know me or my history.I take the oxycontin and instead now morphine for pain from a disease called "intestinal cystitis ) which I have posted her so many time I am afraid people will be upset if I continue. It involves chronic pain.
Is this an attempt to avoid life as we know it?
Absolutely. I have suicidal thoughts quite often and figure it is better to sleep the day away than end all the rest of the possibilities of other days. I have been unable to address y depression because of my physical disease.
It's not surprising the honeymoon with morphine has ended. Opiates generally give the giggles for a few weeks for their intended use and gradually become very potent drugs that require withdrawal.
I would have welcomed to have the giggles indeed . I have been at the point where I would not have minded being high. Anything but what I had been feeling. Unfortunately in my personal experience when I am treating pain none of this has ever made me high. For reference I used to get high about 25 or 30 years ago.
I can see where the possibility that it has helped the removal of perphenazine as u-receptors have been explored in schizophrenia.
I am lost with what you are trying to say?
Bupenorphine and amineptine together seem to be two addictive agents combined. I don't know what would occur when that happens.
I am not sure but you seem to be addressing the addiction potential single mindedly?A little background. My prescribing doc has been on my case for a couple of years now because I dislike the fact that I need pain medication so much I refused to take the amount he prescribed and was left with constant breakthrough pain and in the end because I chose to have good pain management as he put it I created more problems for myself. The Avinza was prescribed two years ago and I was afraid to try it but I finally was pushed into a corner with the pain stuff and had to make a change. I am afraid to some one who is single minded on this topic, and I have at times been myself, this all sounds like a bunch of rationalizations. Alas there is nothing I san do about that on this board that I know of.
I do appreciate the input. There are times in my life it might have been helpful although I doubt you would have gotten through to me.
Posted by yxibow on July 29, 2008, at 14:38:17
In reply to Re: Where to go with Morphine? » yxibow, posted by Quintal on July 29, 2008, at 9:02:03
> >Is this an attempt to avoid life as we know it? I don't wish to be ad-hominem but if there is this history in your profile, I'm not quite sure how you got onto opiates in the first place. It does ring a little bit of addiction, or at least avoidance of life, which although may feel good, well --- it isn't really a "cure" for depression, since avoidance is one quality. Just a thought.
>
> Let's not jumpt to conclusions here. Oky has said in the past that she is being treated by a pain specialist, I suppose for some sort of chronic pain condition. She isn't addicted to street drugs and she isn't taking opiates without a prescription or medical supervision.
>
> >Best be careful with morphine -- it is primarily used for palleative care (end of life or major trauma). At some point there is no point of return without heroic effort, [usually though on IV drips.]
>
> I don't know what on Earth you mean here. I would think the pain specialist, or indeed any doctor would be aware of all the potential pitfalls of morphine. He must have reason to believe it's the best option in Oky's particular set of circumstances.
>
> QTrue -- I did say that I hope he had a psychiatrist who specializes in addiction medication, its not an epithet, its an extra set of studying, at least in the US, so that you can get past the crappy DEA. Otherwise you can't dispense this stuff.
And yes, I was just saying that morphine is more used for palleative care in say a nursing home where it can be monitored. But if his doctor thinks its warranted, well god help him. That's all I was saying. We can agree to disagree.
-- Jay
Posted by okydoky on July 29, 2008, at 14:45:54
In reply to Re: Where to go with Morphine? » Quintal, posted by yxibow on July 29, 2008, at 14:38:17
I don't want to be in the middle of this but I do not see a disagreement, only the beginnings of a discussion. Perhaps heated, perhaps not.
I have no trouble answering any question you might have. I am so long winded I would certainly like to wait and not feel obnoxious by telling you my entire history which you probably do not want to read.
Posted by yxibow on July 30, 2008, at 0:51:09
In reply to Re: Where to go with Morphine?, posted by okydoky on July 29, 2008, at 14:45:54
> I don't want to be in the middle of this but I do not see a disagreement, only the beginnings of a discussion. Perhaps heated, perhaps not.
>
> I have no trouble answering any question you might have. I am so long winded I would certainly like to wait and not feel obnoxious by telling you my entire history which you probably do not want to read.
>Sorry to offend -- and no, there is no heated nature here, I'm just here to post views and hopefully help people and maybe I overstep my bounds sometimes.
Hopefully I didn't offend you too much and we can call it a draw.
-- Jay
Posted by okydoky on July 30, 2008, at 10:12:54
In reply to Re: Where to go with Morphine? » yxibow, posted by Quintal on July 29, 2008, at 9:02:03
I forget on this site that my appreciation should not be taken for granted. I am always worried that people think it I thank you I am taking "sides" as I have been accused of on another board and seen it happening on a particular board lot. Apparently only those one agrees with are thanked the others are snubbed. It is childish to say the least.
With all that as background.
Thank you,
oky
oky
Posted by okydoky on July 30, 2008, at 10:16:09
In reply to Re: Where to go with Morphine? » okydoky, posted by yxibow on July 30, 2008, at 0:51:09
"I can see where the possibility that it has helped the removal of perphenazine as u-receptors have been explored in schizophrenia."
I am interested in what you mean? I appologise for not understanding it. I am sure it is very direct.
Thanks,
oky
Posted by yxibow on July 30, 2008, at 12:16:32
In reply to Re: Where to go with Morphine? » yxibow, posted by okydoky on July 30, 2008, at 10:16:09
> "I can see where the possibility that it has helped the removal of perphenazine as u-receptors have been explored in schizophrenia."
>
> I am interested in what you mean? I appologise for not understanding it. I am sure it is very direct.
>
>
> Thanks,
>
>
> oky
>Sigmoid receptors (and I'm not an expert on receptors) may play a role in schizophrenia, so there could be an infinitesimal connection.
-- tidings
Jay
This is the end of the thread.
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