![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 31. This is the beginning of the thread.
Posted by LostBoyinNC45 on February 25, 2014, at 0:15:10
I have over the years, read many many posts by laypersons, by "armchair psychopharmacologists" whom I would describe as obsessed with drugs. And much of the "advice" Ive read is very poor. I have privately wondered if anybody has ever died or been hospitalized as a result of acting upon psychopharmacology "advice" they got off of this forum? Or gotten into legal trouble offline as a result of "ideas" they originally got from perceived "experts" on psychobabble?
This is not a dig, its an honest concern. I realize many on this forum are TRD and therefore, desperate individuals. As a concrete example, I know discussion of opiate narcotics for mood and anxiety disorders is very much tolerated here. Although there is not a single opiod narcotic that is FDA approved for mood or anxiety disorders. And thats just one example of "iffy" psychopharmacology "advice" Ive read here over the years.
Even if such event(s) have occurred, I strongly doubt it would be admitted here.
Eric
Posted by Lou Pilder on February 25, 2014, at 11:54:27
In reply to Anybody died because of psychobabble?, posted by LostBoyinNC45 on February 25, 2014, at 0:15:10
> I have over the years, read many many posts by laypersons, by "armchair psychopharmacologists" whom I would describe as obsessed with drugs. And much of the "advice" Ive read is very poor. I have privately wondered if anybody has ever died or been hospitalized as a result of acting upon psychopharmacology "advice" they got off of this forum? Or gotten into legal trouble offline as a result of "ideas" they originally got from perceived "experts" on psychobabble?
>
> This is not a dig, its an honest concern. I realize many on this forum are TRD and therefore, desperate individuals. As a concrete example, I know discussion of opiate narcotics for mood and anxiety disorders is very much tolerated here. Although there is not a single opiod narcotic that is FDA approved for mood or anxiety disorders. And thats just one example of "iffy" psychopharmacology "advice" Ive read here over the years.
>
> Even if such event(s) have occurred, I strongly doubt it would be admitted here.
>
> EricEric ,
You wrote,[..."armchair psychopharmacologists"...I...wondered if anyone had died...advise they got off this forum...]
The ones that could be the most vulnerable to the advice here could be the children that peek through the portals of this website after school or the children that their parents look in here that are drugging their child in collaboration with a psychiatrist/doctor. Then there are the adults that could have died from these drugs also.
There are statistics that could be accurate pertaining to the members that have died here as to if or if not their deaths could be attributed to the drugs being allowed to be promoted here. The aspect that these drugs could increase suicidal thinking could mean that there could be members here that have committed suicide as a result of following the advice of the "armchair psychopharmacologists" that you describe. This is all because the advice is considered to be supportive on the grounds that whatever is posted in a post that is not sanctioned, Mr Hsiung considers those statements in the post to be supportive. Supportive of what, I ask.
So readers could be led to believe that by reading from others to take mind-altering drugs that have chemicals in them that have been used to commit mass-murder, and kill rats and insects and parasitic worms, is supportive here. And worse, if the drugs do not kill them, they could become addicted to them and get a life-ruining condition or go into a mind-altered state to kill others.
But it is much more than that. For readers do come here in a depressed state looking to be freed from addiction and depression. And what is worse, the drugs could be in a class of mind-altering drugs that increase depression and lead the taker of the drug to kill themselves, all the while thinking that the drugs that the other members promote to them, will stop the depression, which a subset of readers could see through that as being a great deception.
The children, whose parents come here to get advice to drug their child that is in depression, could kill themselves as a result of the parent thinking that these drugs promoted here will somehow remedy the child's depression. The child could not know that the drugs could increase suicidal thinking, nor does the child usually have an understanding that they could become addicted to the drug that the parent is giving them. And when the drug is stopped, the child could be in a mind-altered state that is so awful, that the child could go out and kill themselves and others with them. This is happening on the news over and over, yet today, the drug companies and the psychiatrists that collaborate with parents to drug children, (redacted by respondent). You see, taking these mind-altering drugs could have effects way beyond after the drug is stopped. And are the parents advised of that when those here are advising parents to give their advice on how to drug their child? How many deaths will it take before (redacted by respondent)
Lou
Posted by LostBoyinNC45 on February 25, 2014, at 12:16:19
In reply to Lou's response-blwnihndhawyn » LostBoyinNC45, posted by Lou Pilder on February 25, 2014, at 11:54:27
Lou,
I have always been perplexed at how discussion of prescription opiate narcotics, prescribed "off label" for depression and anxiety...is tolerated at this forum. An example is the FDA approved drug called "bupe" for heroin addicts. While there is anecdotal evidence "bupe" has anti-depressant effects and might be useful in some TRD cases, I have for years been mildly concerned about how opiates are allowed to be discussed here.
If this forum was a forum devoted to say, patients who use pain clinics or a forum devoted to substance abuse recovery, I would not have that attitude and concern. But this forum, by its very name of "psychobabble," is focused on mental illness.
No opiate drug of any type is FDA approved for any mental illness and personally, I want it to stay that way.
Bupe is just one example of an opiate drug that is not FDA approved for mental illness is discussed here openly. I have seen other "off label" discussions of harder narcotics discussed on this forum at times past.
I can also foresee a scenario where a severely ill outpatient reads posts here from "internet psychopharmacology experts" and then going to their own psychiatrists to ask about such "off label" treatments. And the psychiatrist, knowing nothing much about psychobabble, then labels the patient as a "drug seeker" of non FDA approved drugs that are controlled substances...something that looks extra really bad on a mental patient's record.
I also find it interesting that when treatment of sleep apnea as an adjunctive medical treatment is posted here for discussion, it gets moved to the "alternative" section of the forum. (CPAP therapy is a non controlled, non addictive, very safe and many clinical trials suggesting strongly CPAP is effective for depression when sleep apnea is present). Yet open and unlimited discussion of prescription narcotic painkillers is unconditionally tolerated here.
I find that VERY interesting. And find it disturbing.
Anyway, I wonder if the DEA has ever taken a look at this forum?
Eric, AKA "LostBoyinNC"
Posted by SLS on February 25, 2014, at 12:36:35
In reply to Re: Lou's response-blwnihndhawyn » Lou Pilder, posted by LostBoyinNC45 on February 25, 2014, at 12:16:19
> I have always been perplexed at how discussion of prescription opiate narcotics, prescribed "off label" for depression and anxiety...is tolerated at this forum
Do you embrace your freedom of speech to say such things? I do. Actually, it is my impression that it is more of a privilege than it is a civil right on Psycho-Babble. Whatever it may be, you are advocating for suppression of speech. LOL.
Why was Galileo Galilei not tolerated by the church for insisting that the sun was at the center of the solar system?
Off label?
You are no more a doctor to deem a treatment dangerous than others are to advocate it.
- Scott
Posted by Lou Pilder on February 25, 2014, at 13:48:46
In reply to Re: Lou's response-blwnihndhawyn » Lou Pilder, posted by LostBoyinNC45 on February 25, 2014, at 12:16:19
> Lou,
>
> I have always been perplexed at how discussion of prescription opiate narcotics, prescribed "off label" for depression and anxiety...is tolerated at this forum. An example is the FDA approved drug called "bupe" for heroin addicts. While there is anecdotal evidence "bupe" has anti-depressant effects and might be useful in some TRD cases, I have for years been mildly concerned about how opiates are allowed to be discussed here.
>
> If this forum was a forum devoted to say, patients who use pain clinics or a forum devoted to substance abuse recovery, I would not have that attitude and concern. But this forum, by its very name of "psychobabble," is focused on mental illness.
>
> No opiate drug of any type is FDA approved for any mental illness and personally, I want it to stay that way.
>
> Bupe is just one example of an opiate drug that is not FDA approved for mental illness is discussed here openly. I have seen other "off label" discussions of harder narcotics discussed on this forum at times past.
>
> I can also foresee a scenario where a severely ill outpatient reads posts here from "internet psychopharmacology experts" and then going to their own psychiatrists to ask about such "off label" treatments. And the psychiatrist, knowing nothing much about psychobabble, then labels the patient as a "drug seeker" of non FDA approved drugs that are controlled substances...something that looks extra really bad on a mental patient's record.
>
> I also find it interesting that when treatment of sleep apnea as an adjunctive medical treatment is posted here for discussion, it gets moved to the "alternative" section of the forum. (CPAP therapy is a non controlled, non addictive, very safe and many clinical trials suggesting strongly CPAP is effective for depression when sleep apnea is present). Yet open and unlimited discussion of prescription narcotic painkillers is unconditionally tolerated here.
>
> I find that VERY interesting. And find it disturbing.
>
> Anyway, I wonder if the DEA has ever taken a look at this forum?
>
> Eric, AKA "LostBoyinNC"Eric,
Can a doctor prescribe "bupe" to a person for depression, or is the drug only prescribed to a person for pain or to a person addicted to narcotic drugs, to give to an addicted person a substitute addiction?
Lou
Posted by SLS on February 25, 2014, at 14:34:07
In reply to Lou's reply-dudoktoarz? » LostBoyinNC45, posted by Lou Pilder on February 25, 2014, at 13:48:46
> to give to an addicted person a substitute addiction?
Try walking a few steps in the shoeless feet of a homeless heroin addict who sells her body daily to get her next fix. Suboxone allows many of these people to enter the workforce and build for themselves a life of sobriety and independence.
- Scott
Posted by LostBoyinNC45 on February 25, 2014, at 14:45:21
In reply to What kind of life would you give a heroin addict? » Lou Pilder, posted by SLS on February 25, 2014, at 14:34:07
suboxone is perfectly fine for such a person. That is not what I am discussing here. suboxone or "bupe" is FDA approved for exactly such a use...heroin or narcotics addiction. I agree suboxone is a Godsend for heroin addicted individuals.
However, allowing discussions of the use of this narcotic drug "bupe" and other narcotics for the off label, non FDA approved treatment of difficult to treat psychiatric conditions such as depression is...morally bankrupt. And could potentially have legal consequences, IMO. Its foreseeable, IMO.
Now if "bupe" were to get formal FDA approval for refractory depression, I would not be complaining about the public discussion of this drug on this forum. But until "bupe" is formally FDA approved for TRD, the "freedom of speech" argument is laughable.
Eric> > to give to an addicted person a substitute addiction?
>
> Try walking a few steps in the shoeless feet of a homeless heroin addict who sells her body daily to get her next fix. Suboxone allows many of these people to enter the workforce and build for themselves a life of sobriety and independence.
>
>
> - Scott
Posted by SLS on February 25, 2014, at 15:38:39
In reply to Re: What kind of life would you give a heroin addict?, posted by LostBoyinNC45 on February 25, 2014, at 14:45:21
I wasn't talking to you.
- Scott
Posted by Lou Pilder on February 25, 2014, at 20:47:08
In reply to Re: Lou's response-blwnihndhawyn » Lou Pilder, posted by LostBoyinNC45 on February 25, 2014, at 12:16:19
> Lou,
>
> I have always been perplexed at how discussion of prescription opiate narcotics, prescribed "off label" for depression and anxiety...is tolerated at this forum. An example is the FDA approved drug called "bupe" for heroin addicts. While there is anecdotal evidence "bupe" has anti-depressant effects and might be useful in some TRD cases, I have for years been mildly concerned about how opiates are allowed to be discussed here.
>
> If this forum was a forum devoted to say, patients who use pain clinics or a forum devoted to substance abuse recovery, I would not have that attitude and concern. But this forum, by its very name of "psychobabble," is focused on mental illness.
>
> No opiate drug of any type is FDA approved for any mental illness and personally, I want it to stay that way.
>
> Bupe is just one example of an opiate drug that is not FDA approved for mental illness is discussed here openly. I have seen other "off label" discussions of harder narcotics discussed on this forum at times past.
>
> I can also foresee a scenario where a severely ill outpatient reads posts here from "internet psychopharmacology experts" and then going to their own psychiatrists to ask about such "off label" treatments. And the psychiatrist, knowing nothing much about psychobabble, then labels the patient as a "drug seeker" of non FDA approved drugs that are controlled substances...something that looks extra really bad on a mental patient's record.
>
> I also find it interesting that when treatment of sleep apnea as an adjunctive medical treatment is posted here for discussion, it gets moved to the "alternative" section of the forum. (CPAP therapy is a non controlled, non addictive, very safe and many clinical trials suggesting strongly CPAP is effective for depression when sleep apnea is present). Yet open and unlimited discussion of prescription narcotic painkillers is unconditionally tolerated here.
>
> I find that VERY interesting. And find it disturbing.
>
> Anyway, I wonder if the DEA has ever taken a look at this forum?
>
> Eric, AKA "LostBoyinNC"Eric,
I do agree with you in that discussion on this forum is directed for support and education and that discussion of bupe for depression could be in many jurisdictions to be illegal for bupe to be prescribed for depression. There are jurisdictions that allow prescribers to use any approved drug for anything that they want to prescribe it for. So in those jurisdictions a prescriber could prescribe bupe for anxiety/depression. I understand that the U.S. is one of those jurisdictions. But I have not read of that a psychiatrist/doctor in the U.S. does prescribe bupe for depression. But I agree with you that a discussion here about taking bupe for depression could cause one to ask their prescriber for the drug, thinking that the discussion is supportive, which could lead a subset of people to think that it is a right drug to take. The issue here is about that there is an advocacy by posters to take the drug for depression that is considered by the administration to be supportive by the nature that those type of posts remain unsanctioned so that readers could think that the advocacy to take the drug for depression is supportive here.
I guess that posters could advocate anything here as long as it is not illegal in regards to what they are advocating. But your point is that this is a mental-health forum which could limit the advocating of anything that could be harmful to one here, and I agree with you. The question is then if it could be harmful for one to take bupe for depression. Well, bupe is not approved for depression, but for pain management and in the use of substituting an addictive drug for another addictive drug.
So hypothetically, if I was the manager of this forum, I would intercede in discussions concerning the advocating of taking bupe for depression with something like:
[...please do not advocate the taking of a narcotic/addictive drug for depression, for that drug is not approved for depression even though in some jurisdictions a prescriber can prescribe any approved drug {off-label} for anything that they think is appropriate...].
Lou
Posted by Lou Pilder on February 25, 2014, at 21:35:01
In reply to What kind of life would you give a heroin addict? » Lou Pilder, posted by SLS on February 25, 2014, at 14:34:07
> > to give to an addicted person a substitute addiction?
>
> Try walking a few steps in the shoeless feet of a homeless heroin addict who sells her body daily to get her next fix. Suboxone allows many of these people to enter the workforce and build for themselves a life of sobriety and independence.
>
>
> - ScottScott,
You wrote,[...Suboxone allows many of these people (heroin addicts) to enter the workforce and build themselves a life of sobriety and independence...].
The strategy of giving an addict their drug is an old strategy and is used today. And it could make sense in some thinking, for by giving the addict their drug, they do not have to commit crime or take the risk of disease from contaminated needles and do not have to suffer withdrawal from the drug. But what about as to what could happen to the addict's body from taking the drug as time runs? The effects of taking opium are well-known. The opium dens in parts of Asia could tell one that. And if one wants to be free from the drug, is there an easy way out? And if the addiction to heroin is substituted with an addiction to Suboxone, this is not a cure for heroin addiction at all, for if one would then want to be free from Suboxone, there could be a withdrawal even worse than the withdrawal from heroin and the life-effects from taking Suboxone could be the same as from heroin.
You see, Suboxone is an old drug, a drug that is a chemically altered form of the chemical in the poppy plant, like morphine. Heroin is a chemically altered form of morphine. So giving a heroin addict Suboxone could be considered to be giving them a different form of the poppy plant's chemical that stops the withdrawal just as if you gave the addict heroin. So the addict taking Suboxone can go to work without withdrawal just as if the addict took heroin. The Suboxone can be obtained in place of heroin, but there are still the effects of Suboxone to be had when the addict wants to be free from that drug.
Now when one wants to be free from heroin, taking another drug that has chemicals from the poppy plant in it, could push them further into addiction, for when they want to be free from the Suboxone, they have addicted themselves further from taking more narcotic chemicals. Now they could have a greater addiction and a greater withdrawal to deal with. And little by little, the drug dehumanizes the taker of the drug and they could exit life and be a dehumanized shell of a person, loosing their sex life and thyroid issues and osteoporosis and much more...
Lou
Posted by LostBoyinNC45 on February 25, 2014, at 21:40:07
In reply to Lou's reply-heymablofflabl » LostBoyinNC45, posted by Lou Pilder on February 25, 2014, at 20:47:08
This...
Eric
> So hypothetically, if I was the manager of this forum, I would intercede in discussions concerning the advocating of taking bupe for depression with something like:
> [...please do not advocate the taking of a narcotic/addictive drug for depression, for that drug is not approved for depression even though in some jurisdictions a prescriber can prescribe any approved drug {off-label} for anything that they think is appropriate...].
> Lou
Posted by Phillipa on February 25, 2014, at 22:31:16
In reply to Re: Lou's reply-heymablofflabl » Lou Pilder, posted by LostBoyinNC45 on February 25, 2014, at 21:40:07
Osteoporosis and hypothyroidism never took an opoid other than post surgery what happened to me? Phillipa
Posted by SLS on February 25, 2014, at 23:55:43
In reply to Lou's reply-ifuwnttuentrintolyf » SLS, posted by Lou Pilder on February 25, 2014, at 21:35:01
http://www.dr-bob.org/babble/admin/20131217/msgs/1061309.html
- Scott
Posted by Dr. Bob on February 26, 2014, at 1:57:03
In reply to Anybody died because of psychobabble?, posted by LostBoyinNC45 on February 25, 2014, at 0:15:10
> I have privately wondered if anybody has ever died or been hospitalized as a result of acting upon psychopharmacology "advice" they got off of this forum? Or gotten into legal trouble offline as a result of "ideas" they originally got from perceived "experts" on psychobabble?
>
> Even if such event(s) have occurred, I strongly doubt it would be admitted here.No adverse events like that have been reported, and the adverse event reporting system:
http://www.dr-bob.org/babble/faq.html#advent
has been in place since 2002. You can question what I'm reporting, but reports of adverse events could also be questioned.
Bob
Posted by Dr. Bob on February 26, 2014, at 2:11:23
In reply to Freedom of speech? Yeah, whatever. » LostBoyinNC45, posted by SLS on February 25, 2014, at 12:36:35
> Do you embrace your freedom of speech to say such things? I do. Actually, it is my impression that it is more of a privilege than it is a civil right on Psycho-Babble. Whatever it may be, you are advocating for suppression of speech. LOL.
Some posters may wish to advocate for freedom of speech, others for suppression of speech. I'm not sure either "side" is going to convince the other, so I'd like to redirect the former. Here's a link:
http://www.dr-bob.org/babble/admin/20131217/msgs/1061352.html
Thanks,
Bob
Posted by Lou Pilder on February 26, 2014, at 11:11:08
In reply to Re: Anybody died because of psychobabble?, posted by Dr. Bob on February 26, 2014, at 1:57:03
> > I have privately wondered if anybody has ever died or been hospitalized as a result of acting upon psychopharmacology "advice" they got off of this forum? Or gotten into legal trouble offline as a result of "ideas" they originally got from perceived "experts" on psychobabble?
> >
> > Even if such event(s) have occurred, I strongly doubt it would be admitted here.
>
> No adverse events like that have been reported, and the adverse event reporting system:
>
> http://www.dr-bob.org/babble/faq.html#advent
>
> has been in place since 2002. You can question what I'm reporting, but reports of adverse events could also be questioned.
>
> BobMr. Hsiung,
You wrote,[...no adverse events like that have been reported (to the adverse event reporting system of yours here}.
But is reporting to {your} system the *standard* of if an adverse event has happened as a result of people taking the advise given here?
You say that posts here are supportive if they are not sanctioned by you or your deputies. There could be a subset of readers that think that unsanctioned posts mean that you are validating what the post could purport. In the case of Eric's observation, he brings up IMHHHHO a very valid point in relation to that narcotic addictive drugs are being advocated and there is not an administrative intervention. This could lead a subset of readers to think that you and your deputies are ratifying what the poster is advocating. That could lead someone to find a prescriber to give the reader the narcotic addictive drug for depression, or as Eric states, could lead a reader just to ask a prescriber for the narcotic addictive drug which could give the member a record of drug-seeking behavior when the member was not seeking narcotic drugs but thought that psychiatry itself validates the use of the drug for depression because the discussion about the drug was allowed to be seen as supportive by you.
But it is much more than that. For Eric's point goes way beyond just the drug in question. For you allow members to advocate taking combinations of drugs that could kill them. The deaths of those people would be hard to be in your adverse report system because how could anyone know that the dead person took the advice that was un repudiated here?
Lou Pilder
Posted by LostBoyinNC45 on February 28, 2014, at 2:20:03
In reply to Buprenorphine - Freedom of speech - Why not? » sleepygirl2, posted by SLS on February 26, 2014, at 13:12:49
I dont. Why? Simple. Because I dont believe "bupe" will ever become formally FDA approved for chronic, severe depression, not even for chronic, severe TRD.
Ive been reading about "bupe for TRD" since around the time I first developed depression, when I first began seriously reading these kinds of forums. That would be around 1998 or so. That was like, sixteen years ago. And "bupe for TRD" still aint formally FDA approved for anything other than dope addict recovery. The first person I read on the Internet post about "bupe for TRD" was on another forum and at first I perceived the person as an "expert." It later became evident that the person was/is a dope head and a controlled substance seeking nutcase and does not even have a drivers license. LOL
Hence, all discussion here and elsewhere about "bupe for TRD" is nothing but academic. And could easily lead a newbie TRD person to go ask about it to their shrink, offline. With possible bad reputation results for the TRD patient.
I mean, its a scheduled, highly controlled opioid associated with heroin recovery. You cant even drive on the stuff if it remitted some patients. If you remit, but cant drive a car, WTF good is it for? Most people, even most TRD patients, drive a car and have a drivers license.
All this discussion about opioids for TRD is worthless drivel talk and should be actively discouraged. Discouraging it is not suppression of freedom of speech, its about guiding TRD patients along to places that are legal, FDA approved treatments for refractory mood disorders, i.e. ECT, MAOIs, getting a sleep study done and getting treated for sleep apnea if ANY is present...even mild apnea, Abilify plus SSRI, rTMS, exercising a lot and losing weight if obese to lower blood sugar...particularly if diabetes is present as it is well established that diabetes untreated causes severe fatigue, getting out of the house more and forcing yourself to be around people more, getting a part time job, laying out in the sun a lot, etc.
The last thing people that read these forums need is new and more problems ("bupe" induced opiate addiction).
For a heroin junkie who is attempting to recover, "bupe" is from what I have read about it, a very possible Godsend. Kind of like the heroin junkie equivalent of ECT for TRD. But for psychiatric purposes, narcotics have ZERO uses.
Narcotics are for severe physical pain control. And bupe is for narcotic addiction recovery. That is all these drugs are FDA approved for and the government is increasingly cracking down on prescription drug abuse, particularly the government is cracking down on highly scheduled narcotic painkillers as discussed on this forum.
Eric AKA "LostBoyinNC"> I think we should continue to talk about the use of buprenorphine for depression here on Psycho-Babble.
>
> Not so simple.
>
>
> - Scott
Posted by SLS on February 28, 2014, at 2:20:06
In reply to Re: Buprenorphine - Freedom of speech - Why not? » SLS, posted by LostBoyinNC45 on February 26, 2014, at 13:52:22
You are certainly entitled to your opinion as I am mine. If you don't feel that buprenorphine should be used to treat depression, just say so. Why do you feel the need to set in place a posting rule that squelches other opinions?
Perhaps you have no need of creative and heroic treatments. Many people here do. When you decide to write your book, I won't feel bad if you should choose to deride me and my opinions. In the end, that's all this stuff really is. I am very much undecided as to whether or not I will want to try buprenorphine in the future. However, the buprenorphine is likely to taste better than horse piss, which I would gladly imbibe were it to remedy my medical condition. The stakes for me are too high to allow someone like you to remove my alternatives. I have a personal stake in having buprenorphine remain available to me to use to treat my affective illness. I have a personal stake in having buprenorphine remain available to a good friend of mine who had been addicted to heroin.
What is your personal stake in forbidding me from discussing the use of buprenorphine to treat TRD?
Well, for now, I will repost the link to the NIH-sponsored clinical trial of buprenorphine for depression with a smile. - just because I can.
http://clinicaltrials.gov/show/NCT01407575
-----------------------------------------------------
Detailed Description:
Rates of treatment resistant depression (TRD) in randomized controlled trials range from 50-80% using SSRIs and SNRIs. Innovative treatments are sorely needed. Modulation of the opiate system may be a novel treatment approach for TRD. Buprenorphine (BUP) is a partial agonist at mu-receptors, and also displays affinity for kappa and delta receptors. BUP has a favorable safety profile with low risk of respiratory depression, and the pharmacokinetics are not affected by advanced age or renal dysfunction. This combination of mu-agonism and kappa-antagonism produces less dysphoria than methadone, and animal studies suggest that kappa-antagonism may exert antidepressant effects. In this small proof of concept RCT (n=20), the investigators hypothesize that there will be differences between the group receiving buprenorphine and the group receiving placebo for the following: 1) depression, anxiety, and sleep, and 2)activation of the limbic system and brain structures rich in opiate receptors and critical to reward circuits. In addition, the investigators hypothesize that there will not be differences for measures of safety (vital signs, measures of memory and reaction time, and falls) between the two groups. This pilot project will provide compelling preliminary data to support a R01 application to test the efficacy of buprenorphine for these therapeutically challenging patients.
Specific Aims:
Describe the relative safety of BUP in adults with TRD. The investigators hypothesize that there will be no differences in vital signs, measures of memory and reaction time, or falls between the two groups.
Describe the clinical effect of BUP in adults with TRD. The investigators hypothesize that depression, anxiety, sleep, and health-related quality of life, will improve to a greater extent among those receiving BUP.
Characterize the change in the phMRI responses to buprenorphine compared to placebo. The investigators will compare activation of the limbic system (rACC, insula, and amygdala) and brain structures rich in opiate receptors (periaqueductal grey) and critical to reward circuits (nucleus accumbens) before and immediately after administration of BUP or placebo.The investigators are recruiting 20 community-dwelling adults, age 21 and older, who have tried at least two FDA-approved antidepressant medications at therapeutic doses each for at least 6 weeks during this episode of depression, and are still depressed
-----------------------------------------------------
- Scott
Posted by LostBoyinNC45 on February 28, 2014, at 2:20:08
In reply to Re: Buprenorphine - Freedom of speech - Why not? » LostBoyinNC45, posted by SLS on February 26, 2014, at 14:45:05
I have no personal "stake" regarding that. My beef with "bupe for TRD" lies in the fact it is an ad hoc treatment for which there is poor scientific understanding of. And also I dont like the fact that bupe is controlled and physically addictive, to me that makes a bad option for TRD. Also, as I have mentioned multiple times, you cant drive a vehicle legally while taking the stuff.
Finally, going back to the ad hoc treatment part, "bupe for depression" is not formally FDA approved for mood problems. And ANYTIME you go around asking for narcotics, you will be suspected by the medical community as a controlled drug seeker. Which is a really, really, really bad thing to have written down in your psychiatric and medical records.
If the FDA suddenly approves "bupe for TRD" in the future, I will change my attitude about it. Until then, to hell with bupe. Find another way, science, Im sick of psychiatry's ad hoc, throw sh*t together approach. I never did like it and still dont. Last week I read on the news some researchers had discovered a biological marker of a predictor of depression in young men, they were doing swipes of the insides of teenage boys mouths and measuring the cortisol levels. The researchers claim the cortisol levels were elevated in some and was a medical predictor of future depression.
I'd like to see more stuff like that, respectable hard science stuff and it pushes clinical depression into the "its a real illness" arena. If it gets pushed into the "its a real illness" arena, then I get more respect from society as a depressed person. Otherwise, its "just psychological b*llsh*t, pull yourself up by your bootstraps."
A bunch of people refuse to acknowledge mental illness because of the lack of science behind it. Things will never change until that part is forced to change.
Eric
> What is your personal stake in forbidding me from discussing the use of buprenorphine to treat TRD?
>
Posted by LostBoyinNC45 on February 28, 2014, at 2:21:56
In reply to Re: Buprenorphine - Freedom of speech - Why not?, posted by SLS on February 26, 2014, at 21:06:35
Do you have anything else to do with your time than post stupid sh*t on the Internet?????
Eric AKA "LostBoyinNC"> > > A bunch of people refuse to acknowledge mental illness because of the lack of science behind it.
> >
> > I am not terribly concerned with the ignorance extant in this particular bunch of people unless they are in a position to exert deleterious effects on the pursuit of improvement in the lives of the mentally ill.
> >
> > I disagree with your supposition that there is a lack of science in the study of mental illness. I have been researching the medical literature since 1983. I have watched it evolve over time. In my estimation, modern scientific research into mental illnesses was in place by the late 1960s, and has grown exponentially. You can gain an appreciation for this by using Medline as a timeline.
> >
> > The following link will search the Medline database for occurrences of the terms "major depressive disorder" or "major depression".
> >
> > http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=pubmed&form=4&term="major depressive disorder" OR "major depression"&dispmax=100
> >
> > It might be interesting to jump ahead to the last page to appreciate how great were the efforts to study mental illness scientifically in the 1950s.
> >
> > Hopefully, the link will work properly.
>
> Nope.
>
> Let's try this:
>
> -----------------------------------------------
>
> http://www.ncbi.nlm.nih.gov/pubmed?form=4&term="major depressive disorder" OR "major depression"&dispmax=20&cmd=search
>
> -----------------------------------------------
>
>
> - Scott
Posted by SLS on February 28, 2014, at 2:23:34
In reply to , posted by on December 31, 1969, at 18:00:00
> Do you have anything else to do with your time than post stupid sh*t on the Internet?????
Do you have anything else to do with your time than post personal attacks on the Internet when you lose an argument?
;-)
- Scott
Posted by Willful on February 28, 2014, at 17:13:54
In reply to Re: Buprenorphine - Freedom of speech - Why not? » SLS, posted by LostBoyinNC45 on February 28, 2014, at 2:20:03
I recall your pointing out that none of us are doctors.
And where did you get your medical license? at your local gun shop?
Posted by Fayeroe on March 2, 2014, at 3:45:59
In reply to Re: Anybody died because of psychobabble?, posted by Dr. Bob on February 26, 2014, at 1:57:03
Posted by Dr. Bob on March 3, 2014, at 15:36:03
In reply to Re: Anybody died because of psychobabble? You? (nm), posted by Fayeroe on March 2, 2014, at 3:45:59
Posted by Beckett on March 4, 2014, at 1:19:46
In reply to Re: Anybody died because of psychobabble? You? (nm), posted by Fayeroe on March 2, 2014, at 3:45:59
Go forward in thread:
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