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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by pleasehelpmyson on February 5, 2012, at 13:21:34
I've heard these can help people with mental disorders and can be prescribed off label
Posted by SLS on February 5, 2012, at 15:22:43
In reply to Ketamine and Buprenorphine, posted by pleasehelpmyson on February 5, 2012, at 13:21:34
> I've heard these can help people with mental disorders and can be prescribed off label
Yes.
What do you want to know?
- Scott
Posted by pleasehelpmyson on February 5, 2012, at 16:59:39
In reply to Re: Ketamine and Buprenorphine » pleasehelpmyson, posted by SLS on February 5, 2012, at 15:22:43
> > I've heard these can help people with mental disorders and can be prescribed off label
>
> Yes.
>
> What do you want to know?
>
>
> - ScottSeeing that both can habit forming and subject to abuse, do the benefits outway the risks?
Posted by Phillipa on February 5, 2012, at 18:05:21
In reply to Re: Ketamine and Buprenorphine » SLS, posted by pleasehelpmyson on February 5, 2012, at 16:59:39
What age is your Son and what is his diagnosis? Also what meds has he been on in past and on now? Phillipa
Posted by jono_in_adelaide on February 5, 2012, at 20:22:42
In reply to Ketamine and Buprenorphine, posted by pleasehelpmyson on February 5, 2012, at 13:21:34
These are meds of last resort for depression that has resisted everything and then some, and only a few doctors are willing to prescribe them.
What is your sons diagnosis, what meds has he tried and failed on, how old is he, and has he been refered to a specialist treatment center (such as the Menninger Clinic, Mayo Clinic etc)
Posted by pleasehelpmyson on February 6, 2012, at 13:33:25
In reply to Re: Ketamine and Buprenorphine, posted by jono_in_adelaide on February 5, 2012, at 20:22:42
> These are meds of last resort for depression that has resisted everything and then some, and only a few doctors are willing to prescribe them.
>
> What is your sons diagnosis, what meds has he tried and failed on, how old is he, and has he been refered to a specialist treatment center (such as the Menninger Clinic, Mayo Clinic etc)My son is 19 and has suffered with obsessional type OCD from a very young age, which led to acute and chronic anxiety and major depression, and there may be even more going on at this point, although he denies any hallucinations. He's had about 4 years of CBT and regular therapy from 8th through early 12th grade but has always refused to take any psychiatric medications and is now burned out on therapy. You do not have to repeat what you said above. We already know what the protocols are for the majority of the medical community.
Posted by jono_in_adelaide on February 6, 2012, at 16:24:55
In reply to Re: Ketamine and Buprenorphine, posted by pleasehelpmyson on February 6, 2012, at 13:33:25
If he hasnt tried other meds, then I'd say there are several options he should try before even considering thse end if line approaches.
I'd start with an SSRI such as Zoloft (start at 50mg per day, increase to 100, and if needed, 200mg per day), if that doesnt help, try Anafranil 150mg/day.
These safe, simple meds could turn his life around.
Posted by Phillipa on February 6, 2012, at 18:18:42
In reply to Re: Ketamine and Buprenorphine, posted by pleasehelpmyson on February 6, 2012, at 13:33:25
If I'm reading you right being a teen or young adult you are considering the possibility he could either be bipolar or schizophrenic? I only mentioned these as you said denies hallucinations. Which leads me to believe you feel he may experience some. If not please correct me and disreguard my post. Phillipa
Posted by pleasehelpmyson on February 7, 2012, at 6:50:11
In reply to Re: Ketamine and Buprenorphine » pleasehelpmyson, posted by Phillipa on February 6, 2012, at 18:18:42
> If I'm reading you right being a teen or young adult you are considering the possibility he could either be bipolar or schizophrenic? I only mentioned these as you said denies hallucinations. Which leads me to believe you feel he may experience some. If not please correct me and disreguard my post. Phillipa
I honestly don't think he's had any hallucinations. It's clear he's tormented by un-wanted thoughts and he often does rituals, so his OCD is so out-of-control it's hard to tell some-times whether or not he's suffering with something other than his OCD and major depression. We're trying really hard to convince him to take meds., but so far it's like talking to a brick wall.
Posted by alchemy on February 7, 2012, at 20:59:56
In reply to Re: Ketamine and Buprenorphine, posted by pleasehelpmyson on February 7, 2012, at 6:50:11
> I honestly don't think he's had any hallucinations. It's clear he's tormented by un-wanted thoughts and he often does rituals, so his OCD is so out-of-control it's hard to tell some-times whether or not he's suffering with something other than his OCD and major depression. We're trying really hard to convince him to take meds., but so far it's like talking to a brick wall.
Unwanted thoughts can be on the psychosis and schizophrenic side, but if he is also doing rituals, that sounds like OCD.
Honestly, that is a foreign concept to me when there is the possibility that swallowing a pill could change your life and relieve the torment. Is it that he only believes in holistic cures or that the power of the mind should conquer all?
(I think it would most likely be impossible to have a dr. offer ketamine)
Posted by Hugh on February 8, 2012, at 13:57:03
In reply to Re: Ketamine and Buprenorphine, posted by pleasehelpmyson on February 7, 2012, at 6:50:11
>We're trying really hard to convince him to take meds., but so far it's like talking to a brick wall.
Since he refuses to try meds, have you considered neurofeedback? That can sometimes be helpful for OCD. Also, the over-the-counter supplement n-acetylcysteine (NAC) has been shown to reduce OCD symptoms. In a clinical trial, NAC was used as an adjunctive therapy for OCD, at a dosage of 1200 mg twice a day.
Posted by phidippus on February 8, 2012, at 17:00:04
In reply to Ketamine and Buprenorphine, posted by pleasehelpmyson on February 5, 2012, at 13:21:34
Yes, both have had studies supporting their efficacy as antidepressants.
Eric
Posted by pleasehelpmyson on February 8, 2012, at 17:14:07
In reply to Re: Ketamine and Buprenorphine » pleasehelpmyson, posted by alchemy on February 7, 2012, at 20:59:56
> > I honestly don't think he's had any hallucinations. It's clear he's tormented by un-wanted thoughts and he often does rituals, so his OCD is so out-of-control it's hard to tell some-times whether or not he's suffering with something other than his OCD and major depression. We're trying really hard to convince him to take meds., but so far it's like talking to a brick wall.
>
> Unwanted thoughts can be on the psychosis and schizophrenic side, but if he is also doing rituals, that sounds like OCD.
> Honestly, that is a foreign concept to me when there is the possibility that swallowing a pill could change your life and relieve the torment. Is it that he only believes in holistic cures or that the power of the mind should conquer all?
> (I think it would most likely be impossible to have a dr. offer ketamine)He's said that taking meds. will change him into a different person, not meaning it will make him have a "flat effect," but literally he feels he will become someone else
Posted by friendly pitviper on February 8, 2012, at 20:13:49
In reply to Re: Ketamine and Buprenorphine, posted by pleasehelpmyson on February 7, 2012, at 6:50:11
I'm curious where you heard about off-label psychiatric use of these medications. They are not exactly mainstream.
I don't know about ketamine. Buprenorphine is a quirky kind of opiate (it's a partial mu agonist/kappa antagonist/I think it has some interaction with delta receptors but I don't know what kind). I am sort of sceptical as to how addictive it actually is although a lot depends on whether you have reason to think, your son is a person who is at risk for addiction (some people are much more so than others). I haven't heard about opioids being used for OCD though, only depression.
I don't understand why your son is uncomfortable about more mainstream medications.
Posted by pleasehelpmyson on February 9, 2012, at 13:28:57
In reply to Re: Ketamine and Buprenorphine, posted by friendly pitviper on February 8, 2012, at 20:13:49
> I'm curious where you heard about off-label psychiatric use of these medications. They are not exactly mainstream.
>
> I don't know about ketamine. Buprenorphine is a quirky kind of opiate (it's a partial mu agonist/kappa antagonist/I think it has some interaction with delta receptors but I don't know what kind). I am sort of sceptical as to how addictive it actually is although a lot depends on whether you have reason to think, your son is a person who is at risk for addiction (some people are much more so than others). I haven't heard about opioids being used for OCD though, only depression.
>
> I don't understand why your son is uncomfortable about more mainstream medications.There was a recent news report about Ketamine on Fox News, which is where I heard about that, and there have been a number of studies about buprenorphine, starting with a report out of Harvard in 1995 which I found seacrching on the web.
I previously posted why my son is averse to main-stream meds. We don't understand his aversion either.
This is the end of the thread.
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