![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 25 to 49 of 49. Go back in thread:
Posted by undopaminergic on May 28, 2008, at 22:27:09
In reply to Re: Suboxone???? Is it only for Opiates or an Ad Too? » undopaminergic, posted by okydoky on May 28, 2008, at 20:40:23
>
> Based on this would Suboxone be potentially better than Subutex with an antidepressant like amineptine or other DA reuptake inhibiter or agonist? On the other hand maybe I understand you to say the effects for pain might be better with Subutex?
>There is probably no practical difference between them (except if injecting them), but there is a small possiblity of subtle distinctions - the only way to know is to test both.
>
> I see one doc tomorrow who said he would prescribe Parnate. I think I should hold off.
>Let him write the prescription - you can still hold off taking the medication until you feel ready.
> Still in a fog and having worse memory problems with no motivation. Getting on here to ask this was a task. It's remarkable how bad things can get.
>Yes, but it's also amazing how fast things can change for the better.
>
> How is your trial going? Are you still getting positive effects?
>I've taken 0.20 mg more since my last report, which still holds true: the appetite has remained suppressed, my motivation has been stable at the improved level, and so on.
>
> Are you taking the Subutex for depression only? Not for pain? Your post was quite inspirational.
>Fortunately, I have no chronic pains, so I'm taking it (Temgesic) only for its neuropsychiatric effects.
Posted by Crotale on June 1, 2008, at 12:00:50
In reply to Suboxone???? Is it only for Opiates or an Ad Too?, posted by Phillipa on May 25, 2008, at 13:07:47
> I know this is used for opiate addiction no I don't take opiates but the sender of the link the link says it is good for depression too. Is that true? Love Phillipa
I take Buprenex (buprenorphine HCl injectable) for depression and have been taking it for around 8 years. It has the same active ingredient that is in Suboxone, but there are a couple of key differences between the two:
1. As I mentioned, Buprenex is intended for IM or IV injection (I use it IM). Suboxone is a pill intended to be taken sublingually.
2. Buprenex contains a *much* lower dose of buprenorphine, because Suboxone *is* intended to be for drug addicts who have a high tolerance to opioids. (supposedly, the dosage is the same: that is, if you take 0.3mg buprenorphine IM, you are supposed to take 0.3mg SL.) Based on my experience, the 2mg of buprenorphine in a single Suboxone tablet (and this is the lowest dose, mind you) would make a non-tolerant person sick.
3. Suboxone contains, in addition to the 2mg buprenorphine, 0.5mg naloxone. This is to prevent the addicts who are prescribed this drug from injecting it. (Kind of silly IMO, as buprenorphine doesn't get people high anyway.) Basically, the naloxone would block the opioid-agonist effects of the buprenorphine if you tried to inject it (naloxone only works if injected: it isn't absorbed sublingually).
In some countries (e.g., France, Mexico) you can get a SL pill called Temgesic containing a low dose of buprenorphine, similar to the dose in Buprenex. I would probably be taking this instead of Buprenex but it isn't available in the USA, where I live.
Crotale
Posted by Crotale on June 1, 2008, at 12:25:21
In reply to Re: Suboxone???? Is it only for Opiates or an Ad Too?, posted by undopaminergic on May 27, 2008, at 18:52:52
> Some doctors mistakenly believe that they need a special permission (called a "waiver") to prescribe Subutex or Suboxone.
I've had a terrible time with this since the DATA was passed (I started taking Buprenex several years before then); several pdocs have refused to prescribe Buprenex on the grounds that they don't have a waiver. Fortunately I've found one who actually understands what the law says! I downloaded your letter in case I have problems in the future.
Do you live in the US, and if so how did you get Temgesic?
I had terrible problems with nausea & vomiting when I first started taking buprenorphine (0.3mg q.i.d.). I dealt with the problem by dropping back to 0.15mg q.i.d., then increasing it gradually. Some other side effects I tend to get are: dry mouth, constipation (a pain in the *ss, so to speak <g>), sweating, itching, stimulation (I get this from mu-opioid agonists in general - one of my personal quirks), and possibly some skin irritation and inflammation (am not sure whether the BUP causes/exacerbates the skin problems or not). I've been able to decrease my dose since I started ECT.
To the best of my knowledge respiratory depression from BUP is minimal. I have heard of deaths from overdosage, but never of BUP alone - it was always in combination with something like benzodiazepines.
I'd like to continue hearing about your experience with Temgesic. If I could get my hands on some of this, I'd be happy to switch to it if I could get some; I don't like the amount of medical waste generated by the IM Buprenex (I tried taking it intranasally but it was just too much hassle).
Crotale
Posted by okydoky on June 1, 2008, at 13:39:46
In reply to Re: Suboxone???? Is it only for Opiates or an Ad T » Phillipa, posted by Crotale on June 1, 2008, at 12:00:50
This is all very interesting. I see my urologist tomorrow. He had wanted me to try Suboxone several months ago. My gp says he can and will prescribe it, (took a special course and got special DEA number or something) but never heard of it for anything but addiction and will ony do so if he gets the okay form someone else. Not me!. He is supposed to get in touch with some Rep to discuss it.
All that aside. I will of course need to take some equivalent dose as per the 30mg oxycintin bid. Probably more as I also occasionally take oxy ir or fentora for breakthrough pain.
I would also like to get as much benefit from it as an antidepressant. So which one would be the preferred drug? Pain management is the priority here.
oky
Posted by undopaminergic on June 1, 2008, at 19:52:44
In reply to Re: Suboxone???? Is it only for Opiates or an Ad T, posted by okydoky on June 1, 2008, at 13:39:46
> This is all very interesting. I see my urologist tomorrow. He had wanted me to try Suboxone several months ago. My gp says he can and will prescribe it, (took a special course and got special DEA number or something)
>Remember, that the special number should not be used on a prescription of Suboxone/Subutex for purposes other than opiate addiction. I don't know what the practical consequences of erroneously including the number would be - perhaps it is just for statistics, or perhaps you would be "flagged" as an opiate-addict in some database, causing you to be more carefully watched in the future and making pharmacies more suspicious about your prescriptions, etc. I'm just speculating.
> but never heard of it for anything but addiction and will ony do so if he gets the okay form someone else. Not me!. He is supposed to get in touch with some Rep to discuss it.
>Did you print out the DEA letter and show him?
> All that aside. I will of course need to take some equivalent dose as per the 30mg oxycintin bid. Probably more as I also occasionally take oxy ir or fentora for breakthrough pain.
>
> I would also like to get as much benefit from it as an antidepressant. So which one would be the preferred drug? Pain management is the priority here.
>In general, the antidepressant doses of buprenorphine (BUP) have all been less than 4 mg, but the optimal (or useful) range of doses for this purpose hasn't really been sufficiently investigated. If you wish to explore, use whatever dose of BUP is effective enough for your pain. If you would rather stick to doses that have been found efficacious in depression, use up to about 4 mg of BUP, in combination with another opiate, such as oxycodone, for additional pain control, as required.
Low doses of BUP combine well with other opioids, whereas high doses will antagonise their effects. One of the reasons for using high BUP doses - up to about 32 mg - for addiction-treatment is that they block the effects of heroin.
Posted by okydoky on June 1, 2008, at 22:39:45
In reply to Re: Suboxone???? Is it only for Opiates or an Ad T, posted by undopaminergic on June 1, 2008, at 19:52:44
> Remember, that the special number should not be used on a prescription of Suboxone/Subutex for purposes other than opiate addiction. I don't know what the practical consequences of erroneously including the number would be - perhaps it is just for statistics, or perhaps you would be "flagged" as an opiate-addict in some database, causing you to be more carefully watched in the future and making pharmacies more suspicious about your prescriptions, etc. I'm just speculating.>
I must look like a complete idiot.
I printed out the DEA letter as soon as you posted it.
My pdoc retired a couple years ago and I was only taking Ritalin sr and an occasional perphenazine. I had no where to go so I see my retired gp who works part time as a therapist. In our usual bullshi** the Suboxone came up and he said he could prescribe it. I had not anticipated him being involved with my pain management so I never thought to bring the information. He refused to take my word for it. He is supposed to call me after he clears it up with someone. Not sure who? I spoke with the office personnel on Friday and she said she had put he call in but it had not been returned. He was not interested in my emailing him the information so I forgot. My urologist wanted me to travel about two hours away to get it from a doc he knows. Hopefully my urologist will read the information I bring him tomorrow and prescribe for me. He is an hour and a half away.
If it is not for addiction I see no reason he cannot just write the script. The gp is insisting he provide the first dose in office and then I have to go to get the script.
He would not sanction any use of any other pain medication with the Suboxone he told me. I was concerned about break through pain.My only reason for even attempting to make this change is the information posted on this thread about DA reuptake inhibiters working better with it. I am keenly interested in taking Parnate also. My gp one time explained how the oxycontin permanently erases memory. I cannot remember what all he said.
So it sounds like it is possible to take oxycontin or fentora with it if needed?
Still not sure whether to ask for Subutex or Suboxone? I think the urologist would be open to discussion about the reasons why I would have a preference. I know I have asked once before but could you provide a clear reasoning that I could just copy and bring to him? I take that back. There is plenty her already for me to copy for him to read:
http://www.dr-bob.org/babble/20080519/msgs/831152.html
http://www.dr-bob.org/babble/20080519/msgs/831482.html
The discussion with Scott about Nardil was of interest.
http://www.dr-bob.org/babble/20080528/msgs/832391.html
I am looking at Suboxone/subutx with Amineptine and Memantine to try first. Then I would like to try Parnate again. It worked well before but pooped out and had so many side effects that if I can get Amineptine to work again I would prefer it even if it does not work as well. Nothing ever got rid of the depression wholly.Well Thanks. This all sounds so forward looking and optimistic. Im not sure but that you might imagine that things arent so rosy here. I rarely leave my house. Never clean Like I wrote to you yesterday Now I just never want to be .That is my mindset most of the time. I tried to sleep the entire day today.
If you would rather stick to doses that have been found efficacious in depression, use up to about 4 mg of BUP, in combination with another opiate, such as oxycodone, for additional pain control, as required.That would be at odds with what I am trying to do here, would it not?
I know this is entirely last minute as I see the urologist tomorrow. I leave the house at 11pm. It took me almost an hour and a half jus to write this email to you. That is where I am at .Of course I can always try to communicate with him after the appointment if need be.
Honestly my brain is rapidly turning to mush as my body becomes frail and brittle and painful from it all. Thank you so much again. I can only hope that I have not wasted your time. I see no future but having tried for a way out several times I am worried about what would be left of me if it did not work. If I am to stay around for a while at least let it not be so dam*** painful!
oky
Posted by undopaminergic on June 2, 2008, at 0:33:42
In reply to Re: Suboxone???? Is it only for Opiates or an Ad Too?, posted by undopaminergic on May 28, 2008, at 2:32:05
This message is the fourth (4th) in a series of reports on my experience with buprenorphine (Temgesic). The previous reports can be found at:
1. http://www.dr-bob.org/babble/20080519/msgs/831180.html (26th May)
2. http://www.dr-bob.org/babble/20080519/msgs/831307.html (26th May)
3. http://www.dr-bob.org/babble/20080519/msgs/831558.html (28th May)It is now early in the morning of the 2nd of June 2008, a few hours after the conclusion of my first week of exploring buprenorhpine (BUP) - starting on the 26th of last month. The total weekly consumption amounted to 2.5 mg, yielding an average dose of about 0.35 mg a day.
Yesterday, upon waking, I took three successive doses of 0.2 mg intranasally, separated by approximately 30 minutes to allow time for absorption and assessment of tolerability. The only side effect - noted some time after the third 0.2 mg dose - was slight sedation, which was too mild to produce any notable tendency to nodding, but manifested itself mainly as exophoria, with divergence and double-vision upon relaxation. In other words, the (modest) adverse effects that were noted initally (see report 2) are now barely perceptible, even at a higher dose.
Benefits and effects that have caused little or no distress are discussed below.
The suppression of appetite previously reported has remained in effect - although food intake was notably increased yesterday relative to the preceding days, it was hopefully an exception, as I would prefer to get rid of another 5 kg or so. I have previously not remarked on constipation, as the aforementioned reduction in appetite has precluded an accurate diagnosis of its presence.
The enhanced tolerance to cold has been sustained, but it is not clear whether tolerance to heat is conversely reduced, or whether sweating is increased, as it objectively has been rather hot, with temperatures around 28 degrees Celsius in my office (there is no air-conditioning) a lot of the time.
Pupil diameter has remained reduced, although perhaps slightly less than initially - however, any such mitigation of this classical opiate effect may as well have developed in response to other drugs rather than tolerance. The previously noted paradoxical muscle tension affecting the neck and shoulders has apparently abated, whereas the dryness of the mouth has been variable, but most of the time not troublesome.
The enhanced freedom from distractions of a sexual nature has been sustained, although some temporary physical arousal was noted at least once, temporally connected to the onset of wakefulness.
Alertness, attention and focus have been stable at excellent levels, although some aspects are not notably improved over the immediately preceding period. In particular, the efficiency of reading - including speed and comprehension - has remained substantially improved relative to the already enhanced performance noted in the period immediately preceding BUP. Motivation and initiative have remained considerably improved over preceding baseline performance, whereas laziness and procrastination have stayed diminished. Working memory and executive function - such as planning, rational execution of tasks, and the capacitiy for organisation - have remained consistently elevated to heights that may be unprecedented in my life.
Mood has probably been slightly elevated, but no clear effects on the capacity for satisfaction and enjoyment have been noted. Although interest has improved, there has been little or no enthusiasm and excitement.
The remarkable range of benefits noted soon after starting buprenorphine treatment has thus been sustained at a highly consistent level for about one week without interruption. Such durability and magnitude of beneficial effects has rarely been noted before in my psychopharmacological experience.
Posted by undopaminergic on June 2, 2008, at 1:04:03
In reply to Re: Suboxone???? Is it only for Opiates or an Ad T » undopaminergic, posted by okydoky on June 1, 2008, at 22:39:45
>
> My only reason for even attempting to make this change is the information posted on this thread about DA reuptake inhibiters working better with it.
>That's the theory, which is mainly supported by research in rats. I'm in the process to testing it on myself...
> My gp one time explained how the oxycontin permanently erases memory. I cannot remember what all he said.
>I haven't heard about that.
>
> So it sounds like it is possible to take oxycontin or fentora with it if needed?
>Yes, unless you take very high doses of BUP - probably more than 8 mg would be required to significantly block the effects of other opiates.
> If you would rather stick to doses that have been found efficacious in depression, use up to about 4 mg of BUP, in combination with another opiate, such as oxycodone, for additional pain control, as required.
>
> That would be at odds with what I am trying to do here, would it not?
>What makes you think so?
> I know this is entirely last minute as I see the urologist tomorrow.
>Good luck!
Posted by undopaminergic on June 2, 2008, at 1:18:25
In reply to Re: Suboxone???? Is it only for Opiates or an Ad T » undopaminergic, posted by Crotale on June 1, 2008, at 12:25:21
>
> Do you live in the US, and if so how did you get Temgesic?
>No, I'm in Europe.
> Some other side effects I tend to get are: ... stimulation (I get this from mu-opioid agonists in general - one of my personal quirks),
>Stimulation is what I'm looking for - I'm using it, among other things, to augment my insufficient response to stimulants.
>
> I'd like to continue hearing about your experience with Temgesic.
>I just posted the 4th report, the whole series can be read at:
1. http://www.dr-bob.org/babble/20080519/msgs/831180.html (26th May)
2. http://www.dr-bob.org/babble/20080519/msgs/831307.html (26th May)
3. http://www.dr-bob.org/babble/20080519/msgs/831558.html (28th May)
4. http://www.dr-bob.org/babble/20080528/msgs/832456.html (2nd June)> If I could get my hands on some of this, I'd be happy to switch to it if I could get some; I don't like the amount of medical waste generated by the IM Buprenex (I tried taking it intranasally but it was just too much hassle).
>I've read that the Buprenex can be used sublingually too. I wonder if it could be smoked.
Posted by okydoky on June 2, 2008, at 14:18:44
In reply to Re: Suboxone???? Is it only for Opiates or an Ad T, posted by undopaminergic on June 2, 2008, at 1:04:03
Saw the urologist today with DEA letter in hand. He wants me to go to clinic about two hours away for anthing. Says he would not know how much to prescribe. Now that I have had some time I realise it was a cop out. He was the one who wanted me on it for pain to begin with. It was his idea. The gp has not heard from the drug rep and the ofice assistant insisted today it had to be written with the special DEA number. I give up or in or whatever...
I can't do this anymore.
But really thanks for everything. Sls too. And anyone else I might have left out.
oky
p.s. I'll probably cheer up and bug you all again!
Posted by Crotale on June 2, 2008, at 16:28:32
In reply to Re: Suboxone???? Is it only for Opiates or an Ad T, posted by undopaminergic on June 2, 2008, at 1:18:25
> Stimulation is what I'm looking for - I'm using it, among other things, to augment my insufficient response to stimulants.
I've never met anybody else who got this side effect from opioids. They're more likely to be sedating.
> I just posted the 4th report, the whole series can be read at:
[snip]Will check it out. Thanks.
> I've read that the Buprenex can be used sublingually too. I wonder if it could be smoked.
Not sure why you'd want to smoke it...!
I tried it SL and found it wasn't very well absorbed, but I've heard of some people having success with it.
Crotale
Posted by Crotale on June 2, 2008, at 16:31:20
In reply to Re: Suboxone???? Is it only for Opiates or an Ad T, posted by undopaminergic on June 1, 2008, at 19:52:44
> In general, the antidepressant doses of buprenorphine (BUP) have all been less than 4 mg, but the optimal (or useful) range of doses for this purpose hasn't really been sufficiently investigated.
I only take a total of 1.2mg/day (in divided doses of 0.3mg q.i.d.). The high doses prescribed to addicts are partially to block the effects of heroin or other opioids, as you say. But another reason for prescribing such high doses is because people who are addicted to opioids are liable to have a high tolerance, so the lower doses won't be effective for them.
> If you wish to explore, use whatever dose of BUP is effective enough for your pain.
For pain (if you aren't tolerant) the lower doses should be sufficient. I don't know off the top of my head what the dose equivalence is for oxycodone, but for morphine it's 15mg MS = 0.3mg BUP (both IM), according to the PDR.
> If you would rather stick to doses that have been found efficacious in depression, use up to about 4 mg of BUP, in combination with another opiate, such as oxycodone, for additional pain control, as required.
Why do you suggest another opioid? Additional buprenorphine should work for breakthrough pain.
> Low doses of BUP combine well with other opioids, whereas high doses will antagonise their effects.
I once received MS Contin with buprenorphine (same dose as now -- I've been taking Buprenex for quite a few years & haven't needed to increase it). I found the MS Contin didn't work.
Crotale
Posted by undopaminergic on June 2, 2008, at 20:34:51
In reply to Re: Suboxone???? Is it only for Opiates or an Ad T » undopaminergic, posted by Crotale on June 2, 2008, at 16:31:20
>
> > If you wish to explore, use whatever dose of BUP is effective enough for your pain.
>
> For pain (if you aren't tolerant) the lower doses should be sufficient. I don't know off the top of my head what the dose equivalence is for oxycodone, but for morphine it's 15mg MS = 0.3mg BUP (both IM), according to the PDR.
>
> > If you would rather stick to doses that have been found efficacious in depression, use up to about 4 mg of BUP, in combination with another opiate, such as oxycodone, for additional pain control, as required.
>
> Why do you suggest another opioid? Additional buprenorphine should work for breakthrough pain.
>
> > Low doses of BUP combine well with other opioids, whereas high doses will antagonise their effects.
>
> I once received MS Contin with buprenorphine (same dose as now -- I've been taking Buprenex for quite a few years & haven't needed to increase it). I found the MS Contin didn't work.
>
> CrotaleI'm not very impressed with the efficacy of BUP for pain so far - I certainly don't feel 0.3 mg BUP is anything like 15 mg codeine, let alone morphine. I do find that it diminishes pain, but not so effectively - especially not doses as low as 0.3 mg.
Posted by okydoky on June 3, 2008, at 16:18:47
In reply to Re: Suboxone???? Is it only for Opiates or an Ad T, posted by undopaminergic on June 2, 2008, at 20:34:51
> > Low doses of BUP combine well with other opioids, whereas high doses will antagonise their effects.
For pain (if you aren't tolerant) the lower doses should be sufficient. I don't know off the top of my head what the dose equivalence is for oxycodone, but for morphine it's 15mg MS = 0.3mg BUP (both IM), according to the PDRI need to figure out Subutex amount equivelent to 20-30mg oxycontin bid. Need to know sublingual dose equivalent. Perhaps I can find it with the above information. Thanks. I suppose after 5 years would have some tolerance?
My gp wants information about Suboxane/Subutex among other information articles or abstracts indicating its use for pain. I am having difficulty finding articles or research about it. I found some that suggests NSAIDs with it. I could use some help here. I do not know how to search for articles from other countries which might help. I found little to indicate dose when taking it alone for pain. Gp will prescribe Subutex or Suboxone assuming I can convince him it is used for pain (his words), insisting I take no other opioid with it. If I had the knowledge myself I would try to obtain it without him. Urologist is trying to pon me off onto psychiatric clinic. Says he would not know the dose to prescribe even though it was his suggestion. Everything else he prescribed for me that he had never prescribed before he has looked up or called someone for me. Not this time.
Perhaps I am difficult to deal with. I find it impossible to deal with the medical community in general myself. I suppose the less I get help the harder I am to deal with.
I will search avenues to obtain this for myself.
I would appreciate any help yet again! I guess I have not completely given up yet.
oky
Posted by garylee on June 6, 2008, at 18:53:46
In reply to Re: Suboxone???? Is it only for Opiates or an Ad T » undopaminergic, posted by okydoky on June 1, 2008, at 22:39:45
oky
Can you babble mail me please?
Thanks
Garylee
Posted by garylee on June 6, 2008, at 19:21:09
In reply to Re: Suboxone???? Is it only for Opiates or an Ad T, posted by okydoky on June 3, 2008, at 16:18:47
Hi all
I took a course of Subutex around a year ago now. Wow, what a med... Within a day I noticed a significant improvement in all my disfunctions, mood, sleep, depression and most importantly MOTIVATION.
I had recently started a new job and was constantly late, and was getting warnings in the probation perriod. After a few days of Subutex I was arriving on time (after waking up on the first alarm, managing to fit breakfast, a cigarette and a spot of Sky News in before leaving for work!), getting praise from customers I had helped over the phone and actually recieved employee of the week award!
I was titrated upto a dose of 2mg (I think, could have been 4mg, sure it was 2mg though, lol. 8mg tabs split 4 ways.) and took it sublingually (under the tongue) about half hour before bed along with my Clonazepam and Seroquel. I knocked out quickly and slept like a baby, awaking feeling alert and fresh. The reason I took it a night was beacuse of the instant side effects, blurred vision, feeling (slightly and nicely) high, and general sedation. It felt very much like when I smoked Heroin in a roll up one time.
The remission lasted about 4 weeks, but for some reason seemed to poop out after this time. I was so annoyed, after feeling so good for so long. Though the severe constipation was starting to be a problem. Maybe if I'd started taking laxitives when I first started the med I would not have suffered so bad..?
I would recommend trying Subutex, or any derivative of it to anyone suffering from the same kind of Bipolar or treatment resistant depression as myself.
Feel free to ask anymore Q's.
Thanks
Gary
Posted by BGB on June 6, 2008, at 22:07:34
In reply to Re: Suboxone???? Is it only for Opiates or an Ad T, posted by garylee on June 6, 2008, at 19:21:09
> I was titrated upto a dose of 2mg (I think, could have been 4mg, sure it was 2mg though, lol. 8mg tabs split 4 ways.) and took it sublingually (under the tongue) about half hour before bed along with my Clonazepam and Seroquel. I knocked out quickly and slept like a baby, awaking feeling alert and fresh. The reason I took it a night was beacuse of the instant side effects, blurred vision, feeling (slightly and nicely) high, and general sedation. It felt very much like when I smoked Heroin in a roll up one time.
Hi Gary,Do you think that you would have been able to take the Subutex during the daytime if it were at a much smaller dose? I have ordered some Temgesic tablets, which are 0.2 mg buprenorphine (sublingual). Assuming I actually get them, I am going to try low doses to augment my antidepressants. I'll post and let everyone know if it works or not.
Thanks for your contributions!
BGB =)
Posted by garylee on June 6, 2008, at 23:10:43
In reply to Re: Temgesic 0.2mg Tablets » garylee, posted by BGB on June 6, 2008, at 22:07:34
> > I was titrated upto a dose of 2mg (I think, could have been 4mg, sure it was 2mg though, lol. 8mg tabs split 4 ways.) and took it sublingually (under the tongue) about half hour before bed along with my Clonazepam and Seroquel. I knocked out quickly and slept like a baby, awaking feeling alert and fresh. The reason I took it a night was beacuse of the instant side effects, blurred vision, feeling (slightly and nicely) high, and general sedation. It felt very much like when I smoked Heroin in a roll up one time.
>
>
> Hi Gary,
>
> Do you think that you would have been able to take the Subutex during the daytime if it were at a much smaller dose? I have ordered some Temgesic tablets, which are 0.2 mg buprenorphine (sublingual). Assuming I actually get them, I am going to try low doses to augment my antidepressants. I'll post and let everyone know if it works or not.
>
> Thanks for your contributions!
>
> BGB =)
Yes BGB, if I were taking such small doses as 0.2mg then yes, I would be able to take them in the day time. They have a half life of 12 hours, so say if you take it at 12am before bed expectto take it again at 12 midday. I took it oncea day, but I spsoe you could split the daily dose and have half of it at a time... See how you fair?Cheers
Gary
Posted by Horned One on June 8, 2008, at 12:04:06
In reply to Re: Suboxone???? Is it only for Opiates or an Ad T, posted by garylee on June 6, 2008, at 19:21:09
>The remission lasted about 4 weeks, but for some reason seemed to poop out after this time. I was so annoyed, after feeling so good for so long. Though the severe constipation was starting to be a problem. Maybe if I'd started taking laxitives when I first started the med I would not have suffered so bad..?
Apparently Suboxone users suffer less constipation because the naloxone blocks opiate binding in the GI tract. It isn't supposed to be absrobed from the GI tract, so allegedly doesn't affect the 'mood brightening' effect of buprenorphine.
Posted by undopaminergic on June 10, 2008, at 16:49:31
In reply to Re: Temgesic 0.2mg Tablets, posted by garylee on June 6, 2008, at 23:10:43
> > > I was titrated upto a dose of 2mg (I think, could have been 4mg, sure it was 2mg though, lol. 8mg tabs split 4 ways.) and took it sublingually (under the tongue) about half hour before bed along with my Clonazepam and Seroquel. I knocked out quickly and slept like a baby, awaking feeling alert and fresh. The reason I took it a night was beacuse of the instant side effects, blurred vision, feeling (slightly and nicely) high, and general sedation. It felt very much like when I smoked Heroin in a roll up one time.
> >
> >
> > Hi Gary,
> >
> > Do you think that you would have been able to take the Subutex during the daytime if it were at a much smaller dose? I have ordered some Temgesic tablets, which are 0.2 mg buprenorphine (sublingual). Assuming I actually get them, I am going to try low doses to augment my antidepressants. I'll post and let everyone know if it works or not.
> >
> > Thanks for your contributions!
> >
> > BGB =)
>
>
> Yes BGB, if I were taking such small doses as 0.2mg then yes, I would be able to take them in the day time. They have a half life of 12 hours, so say if you take it at 12am before bed expectto take it again at 12 midday. I took it oncea day, but I spsoe you could split the daily dose and have half of it at a time... See how you fair?
>
> Cheers
>
> GaryI would recommend 2-3 doses a day, and adding a stimulant for reducing somnolence and potentiating the benefits of the buprenorphine.
Posted by Crotale on June 19, 2008, at 8:47:23
In reply to Re: Temgesic 0.2mg Tablets, posted by undopaminergic on June 10, 2008, at 16:49:31
2mg buprenorphine is a *lot* unless you're an addict taking it for maintenance! I take 0.3mg (1 mL Buprenex) q.i.d. and I know if I took 2mg at once it would make me sick to my stomach!
Maybe it's not absorbed as well by the sublingual route? (I take it by IM injection)
As far as side effects.... It's mildly stimulating for me, not sedating, it gives me "the itchies," also causes dry mouth and constipation. No high.
With respect to pain, it works quite well (for ordinary day-to-day pain, like cramps, etc.), with no tolerance (and I've been on it for years).
Crotale
Posted by undopaminergic on June 20, 2008, at 17:37:23
In reply to Re: Temgesic 0.2mg Tablets » undopaminergic, posted by Crotale on June 19, 2008, at 8:47:23
> 2mg buprenorphine is a *lot* unless you're an addict taking it for maintenance!
>I've seen people taking it for depression at 3 mg or so, but all doses for that purpose seem to be under 4 mg. Personally, I'm currently at about 1 mg/day.
> I take 0.3mg (1 mL Buprenex) q.i.d. and I know if I took 2mg at once it would make me sick to my stomach!
>Yes, if you raised the dose too rapidly. No, if you increase it bit by bit over a period of time. Tolerance develops to the nausea.
>
> As far as side effects.... It's mildly stimulating for me, not sedating, it gives me "the itchies," also causes dry mouth and constipation. No high.
>No nausea or itching for me, but it's somewhat sedating in a special way when I take higher doses - even though I always take stimulants too.
> With respect to pain, it works quite well (for ordinary day-to-day pain, like cramps, etc.), with no tolerance (and I've been on it for years).
>I haven't noticed a clear analgesic effect - perhaps a little, though.
I'm now introducing a MAOI too.
Posted by Crotale on June 20, 2008, at 18:17:55
In reply to Re: Temgesic 0.2mg Tablets, posted by undopaminergic on June 20, 2008, at 17:37:23
> > 2mg buprenorphine is a *lot* unless you're an addict taking it for maintenance!
> >
>
> I've seen people taking it for depression at 3 mg or so, but all doses for that purpose seem to be under 4 mg. Personally, I'm currently at about 1 mg/day.Me too (I've decreased it somewhat from 0.3mg q.i.d. since I started ECT). 2mg isn't so huge a total daily dose; I meant 2mg at a time.
I wonder if it makes any difference that I'm taking IM Buprenex. The claim I've heard is that they're equipotent.
> Yes, if you raised the dose too rapidly. No, if you increase it bit by bit over a period of time. Tolerance develops to the nausea.
True: I had to start at single doses of 0.15mg (0.5mL) to prevent vomiting.
> No nausea or itching for me, but it's somewhat sedating in a special way when I take higher doses - even though I always take stimulants too.
Err...what do you mean by "a special way?"
I suspect the itching is the result of stimulation of histamine release, an effect common to mu-agonists (BUP is effectively a morphine-like agonist at low doses). Nausea is also a common opioid side effect.
> I haven't noticed a clear analgesic effect - perhaps a little, though.
Even when you first started taking it?
> I'm now introducing a MAOI too.
Which one? Let me know how the combo works for you.
Posted by undopaminergic on June 25, 2008, at 8:27:27
In reply to Re: Temgesic 0.2mg Tablets » undopaminergic, posted by Crotale on June 20, 2008, at 18:17:55
>
> > No nausea or itching for me, but it's somewhat sedating in a special way when I take higher doses - even though I always take stimulants too.
>
> Err...what do you mean by "a special way?"
>I mean that it's unlike normal sedation or tiredness, because there is no exhaustion, and little, if any, cognitive impairment. The main effect is the strong tendency of the extraocular muscles to relax, so that the visual axes are parallel and double vision results at near distances (such as the computer screen and books). To a lesser extent, a tendency for the muscles of the neck to relax is also present, but not enough so to result in "nodding" (unless I were to *really* take too much).
> I suspect the itching is the result of stimulation of histamine release, an effect common to mu-agonists
>I don't think histamine release is due to mu-opioid receptor stimulation, but due to the direct diffusion of the morphine-like molecules into mast cells, resulting in the displacement of histamine through the cell membrane into the extracellular space where it can reach and stimulate histamine H1 receptors. I don't think itching occurs with synthetic opioids like methadone and fentanyl, which are structurally quite different from poppy alkaloids.
> (BUP is effectively a morphine-like agonist at low doses).
>Partial agonist, and kappa-antagonist. It probably doesn't have much of an effect on delta-opioid receptors at low doses, but at higher concentrations, it acts as an antagonist, and this is a reason why higher doses may be disadvantageous (delta-agonism is generally beneficial, so antagonism is scarcely desirable).
> > I haven't noticed a clear analgesic effect - perhaps a little, though.
>
> Even when you first started taking it?Including then.
> > I'm now introducing a MAOI too.
>
> Which one? Let me know how the combo works for you.
>Just low doses of rasagiline. It doesn't appear to have pronounced effects. Maybe I'll try higher doses at some future point.
Posted by okydoky on July 24, 2008, at 11:13:30
In reply to Re: Temgesic 0.2mg Tablets » undopaminergic, posted by Crotale on June 20, 2008, at 18:17:55
If anyone is still looking for information explaining dose between Buprenorphine IM and sublingual here are a few sites with some information:
http://www.naabt.org/education/pharmacoloy_of_buprenorphine.cfm
http://www.thatspoppycock.com/opiates/buprenorphine.htm
The first here is dosage recommendation for Suboxone/Subutex and the next is for Buprenex (buprenorphine injection)http://www.rxlist.com/cgi/generic/suboxone_ids.htm
http://www.rxlist.com/cgi/generic/buprenorphine_ids.htm
This is the end of the thread.
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