Psycho-Babble Medication Thread 2062

Shown: posts 1 to 15 of 15. This is the beginning of the thread.

 

opiates & depression (to clinicians and patients)

Posted by Elizabeth on January 4, 1999, at 21:07:03

I talked to my doctor today, and he says that he wants
to try adding a partial opiate agonist to the Parnate
(20mg) I am taking. Obviously (as per earlier threads)
opiates such as codeine have helped people's moods. Is
there anyone else out there who has prescribed (or had
prescribed for them) an opiate (agonist or partial
agonist) for a mood or anxiety disorder? I'd like to
hear opinions and impressions...what do and don't they
help with, etc.

 

Re: opiates & depression (to clinicians and patients)

Posted by Chris A. on January 5, 1999, at 18:24:03

In reply to opiates & depression (to clinicians and patients), posted by Elizabeth on January 4, 1999, at 21:07:03

Elizabeth,

After trying multiple meds for my treatment
refractory bipolar depression, we added
buprenorphine(Buprenex). It was on the list of
options to try given to me by a nationally
known mood disorders expert at
a consult over a year ago.
I took the parental
form .1 - .3mg sublingually at HS and then
switched to the injections. It helped with sleep
and with the pain of fibromyalgia. My
severely depressed mood, rapid cycling/mixed
states didn't otherwise seem to respond. My med
cocktail consisted of verapamil and levothyroxine
at the time. We added selegiline (Eldepryl) the
third month. I discontinued The buprenorphine
during a three week hospitalization for suicidal
depression in October. Since it is an agonist/antagonst
it was not difficult to stop it. Personally there were
no problems combining it with the MAOI (but I
understand that caution is advised).

Everyone responds differently. It wasn't effective
for me but understand it has been helpful to
some with mood disorders.

I wish you well,

Chris A.

 

Re: opiates & depression (to clinicians and patients)

Posted by Elizabeth on January 8, 1999, at 14:30:00

In reply to Re: opiates & depression (to clinicians and patients), posted by Chris A. on January 5, 1999, at 18:24:03

Hi Chris. Thanks for all the info!

Can I ask exactly how you took the SL Buprenex? Did you just open the ampule and squirt it under your tongue? Or what? Dr. Bodkin suggested I try using it intranasally as an alternative.

I don't have rapid-cycling moods (just ordinary unipolar melancholic depression that isn't entirely controlled by Parnate) but I do have panic disorder, if this makes a difference. I had my first panic attack in a few weeks the night before last. :-( As far as the depression goes, mostly what I am experiencing right now is low energy, apathy, lack of interest/enjoyment, etc.

How was selegiline for you, BTW? I tried up to 40mg/day but I just had nausea, insomnia, and increased anxiety. It didn't "feel" like the other MAOIs.

 

Re: opiates & depression (to clinicians and patients)

Posted by Chris A. on January 10, 1999, at 3:18:46

In reply to Re: opiates & depression (to clinicians and patients), posted by Elizabeth on January 8, 1999, at 14:30:00


> Can I ask exactly how you took the SL Buprenex? Did you just open the ampule and squirt it under your tongue? Or what? Dr. Bodkin suggested I try using it intranasally as an alternative.

Dear Elizabeth,

Ampules don't pour, so one has to draw the med up in a syringe, remove the
needle(the important part!) and squirt it under your tongue.

The selegiline (Eldepryl) seems to have done me some good. Compared to all of
the other meds I've been on it seemingly is free of
side effects and hasn't caused a mixed state yet.
We have decreased the dose from a high of 50 mg.
when my depressive symptoms were at their worst
down to 25 mg currently. Apparently it is less stimulating
than some of the others. The list of ADs that have created problems
for me is long.

 

Re: opiates & depression (to clinicians and patients)

Posted by marilyn on January 11, 1999, at 11:41:32

In reply to Re: opiates & depression (to clinicians and patients), posted by Chris A. on January 10, 1999, at 3:18:46

>
> > Can I ask exactly how you took the SL Buprenex? Did you just open the ampule and squirt it under your tongue? Or what? Dr. Bodkin suggested I try using it intranasally as an alternative.
>
> Dear Elizabeth,
> Ampules don't pour, so one has to draw the med up in a syringe, remove the
> needle(the important part!) and squirt it under your tongue.
> The selegiline (Eldepryl) seems to have done me some good. Compared to all of
> the other meds I've been on it seemingly is free of
> side effects and hasn't caused a mixed state yet.
> We have decreased the dose from a high of 50 mg.
> when my depressive symptoms were at their worst
> down to 25 mg currently. Apparently it is less stimulating
> than some of the others. The list of ADs that have created problems
> for me is long.
Chris,
How can I find a doctor willing to try buprenesx? I've been through about 20 anti-d's w/no luck. I'm desparate, can you help?

 

Re: opiates & depression (to clinicians and patients)

Posted by judi on January 14, 1999, at 11:28:48

In reply to Re: opiates & depression (to clinicians and patients), posted by Elizabeth on January 8, 1999, at 14:30:00

> Hi Chris. Thanks for all the info!
> Can I ask exactly how you took the SL Buprenex? Did you just open the ampule and squirt it under your tongue? Or what? Dr. Bodkin suggested I try using it intranasally as an alternative.
> I don't have rapid-cycling moods (just ordinary unipolar melancholic depression that isn't entirely controlled by Parnate) but I do have panic disorder, if this makes a difference. I had my first panic attack in a few weeks the night before last. :-( As far as the depression goes, mostly what I am experiencing right now is low energy, apathy, lack of interest/enjoyment, etc.
> How was selegiline for you, BTW? I tried up to 40mg/day but I just had nausea, insomnia, and increased anxiety. It didn't "feel" like the other MAOIs.
As a result of a car accident when I was depressed
I was prescribed vicodin for pain. I was already
taking depakote and klonopin and serzone. (I'm
bipolar) Within a few days I felt really good
(too good according to my psych). Anyway that was
my experience. Good luck.

 

Re: opiates depression

Posted by Cece on February 16, 2001, at 21:31:36

In reply to Re: opiates & depression (to clinicians and patients), posted by judi on January 14, 1999, at 11:28:48

I've had experience with Buprenex, and Vicodin- as anti-depressants (I'm bipolar II).
After I had mentioned several times to my pdoc that Vicodin, which I took for recurrent headaches, was the best anti-depressant for me, he asked me if I'd like to try Buprenex.
No one gave me any advice how to get the stuff out of the ampule, and it was a real pain. I tried it for about 2 weeks, and all I felt was stoned- not the effect I was after at the time.
I have continued to use Vicodin PRN to supplement my regular meds when I need an extra mood uplift/stabilization. I haven't found anything to beat it for calming me down in a positive way. I have not developed a very significant tolerance to it, although I've been using it this way for over 5 years. I do have to take a bit more however- I used to get the help I needed from 1/2tab- now I take a whole tab. My pdoc condones my using it this way, although my prescription is still officially written for headaches. Now I need to find a new pdoc, for a complex of reasons, and I am worried that I will lose this valuable tool since it is a SO off-the-label use.
Any feedback, other experiences, suggestions?

 

Re: opiates depression » Cece

Posted by judy1 on February 17, 2001, at 10:56:49

In reply to Re: opiates depression , posted by Cece on February 16, 2001, at 21:31:36

Hi Cece,
I have also found vicodin to be a very effective AD and also helps my self-injury which somehow is tied in with opiate receptors. Apparently that is why naltrexone is so effective with SI and substance abuse. But your more immediate problem is the new pdoc. Because you use such a small amount (I take 90-100 mg/day when depressed- which probably does qualify as substance abuse. But I am able to stop when manic- kind of an interesting phenomenon). I would suggest having your old pdoc contacting your new one and saying that 1 vicodin is part of your med regime. It's not uncommon, some people use it in panic disorder in addition to depression. You are absolutely not abusing, but may have developed some tolerance (going from 1/2 to 1 tab). I think as long as you are honest with your pdoc, there should be no problem. I wish you the best of luck- Judy

 

Re: opiates depression Judy

Posted by Cece on February 19, 2001, at 2:15:16

In reply to Re: opiates depression » Cece, posted by judy1 on February 17, 2001, at 10:56:49

> Hi Cece,
> I have also found vicodin to be a very effective AD and also helps my self-injury which somehow is tied in with opiate receptors. Apparently that is why naltrexone is so effective with SI and substance abuse. But your more immediate problem is the new pdoc. Because you use such a small amount (I take 90-100 mg/day when depressed- which probably does qualify as substance abuse. But I am able to stop when manic- kind of an interesting phenomenon). I would suggest having your old pdoc contacting your new one and saying that 1 vicodin is part of your med regime. It's not uncommon, some people use it in panic disorder in addition to depression. You are absolutely not abusing, but may have developed some tolerance (going from 1/2 to 1 tab). I think as long as you are honest with your pdoc, there should be no problem. I wish you the best of luck- Judy

Thanks for your support and information, Judy- much appreciated

 

Re: opiates depression » Cece

Posted by shellie on February 19, 2001, at 22:42:09

In reply to Re: opiates depression , posted by Cece on February 16, 2001, at 21:31:36

>
> I have continued to use Vicodin PRN to supplement my regular meds when I need an extra mood uplift/stabilization. I haven't found anything to beat it for calming me down in a positive way. I have not developed a very significant tolerance to it, although I've been using it this way for over 5 years. I do have to take a bit more however- I used to get the help I needed from 1/2tab- now I take a whole tab. My pdoc condones my using it this way, although my prescription is still officially written for headaches. Now I need to find a new pdoc, for a complex of reasons, and I am worried that I will lose this valuable tool since it is a SO off-the-label use.
> Any feedback, other experiences, suggestions?

I have almost the same experience with vicodin, a very small dose (1/2 of 7.5mg) makes me feel a lot less depressed and normal. I am also taking nardil and lamictal. My pdoc is totally totally totally against me taking vicodin, even though I have taken the same dose for two and a half years now. (I wish I could lie to her, but I don't seem to be capable since she's been my pdoc for ten years and I feel very connected to her.) I don't think it will increase into an addiction; but even if it eventually does, nothing else seems to work. I get really tired of my pdoc saying that vicodin is not an antidepressant, but then she's tried me over the years on dozens of meds, most totally not effective. Sometimes I feel like I've lost a few years of my life trying drugs that make me sick or tired. I get tired of being lectured about it, and really anticipate getting an ultimatum from her about it. But I don't want to waste the next twenty years depressed, like I did much of the first twenty. The last few years have been good except for premenstually, until about a year ago when that depressant and sort of sickness lasted throughout the month. I think it may be hormonal.

Someone gave me the name of pillbox--you talk to a doc there and he may prescribe hydrocodeine. Also, I can't remember, but I think it is either in New Zealand or Australia you can order pills that have 5mg of codeine in them along with asperin. And no prescription needed. I did searches of codeine and different countries on goggle.


I'm happy to read that after 5 years, you are only up to one pill a day. That reinforces my belief that I can stay at a relatively small dose and get a lot of benefit. Shellie

 

Re: opiates depression- Shelli and Cece

Posted by judy1 on February 20, 2001, at 13:12:09

In reply to Re: opiates depression » Cece, posted by shellie on February 19, 2001, at 22:42:09

Hi,
There's a message today on the Panic Disorders Institute's BBS (www.algy.com/pdi/BBS) about this issue. Read Dr. S's response- he understands the whole hydrocodone effect. Take care, Judy

 

Re: opiates depression- Shelli and Cece » judy1

Posted by ShelliR on February 20, 2001, at 23:06:30

In reply to Re: opiates depression- Shelli and Cece, posted by judy1 on February 20, 2001, at 13:12:09

> Hi,
> There's a message today on the Panic Disorders Institute's BBS (www.algy.com/pdi/BBS) about this issue. Read Dr. S's response- he understands the whole hydrocodone effect. Take care, Judy

Judy-- Thank you so much for the reference. Everything I read like that makes me trust myself more and more. I am tired of taking a multitude of new drugs, gaining weight, being tired, when all I have to take is so little vicodin and for almost three years have not increased.

The article made me angry--angry that my pdoc won't even consider it; yet she puts me on stuff that seems a lot more dangerous to me, like antipsyhotics and stimulants. Also tried me on effexor (which I immediately at the smallest dose threw up). I think my body knew it was toxic for me. I feel like I have lost the last year with drug trials when I could just be taking vicodin and being very careful. I have printed out all the material I have found on helping refractive depression with hydocodone to show my pdoc, but I know it won't make any difference.

Anyway, thanks again and forgive my tirade. shelli

 

Re: vicodin shellie

Posted by Cece on February 20, 2001, at 23:37:17

In reply to Re: opiates depression » Cece, posted by shellie on February 19, 2001, at 22:42:09

Hi Shellie-

Thanks for your message. I also take Lamictal- along with quite a bit of other stuff- and have found it to be helpful in improving/stabilizing my energy. I'm bipolar II and went untreated for a very long time, which made my disease harder to treat. I'm 52, started suffering badly in my 20's, and only started meds 8 years ago- after spending years and dollars on therapists. Actually, most of the meds that have helped me didn't exist until pretty recently. So, I'm glad you started getting medical help younger

I think that this thread sorta started with questions about Buprenex, which is an opiate. There was a study done at Harvard a few (3-4?) years ago trying it as an anti-depressant, since opiates are KNOWN to be successful AD's for some people. The results were mixed, but at least the subject got some publicity and legitimacy. Maybe you could track it down and bring it up with your pdoc.

Personally, I feel that the issue of addiction, to any med, is really absurd when you're dealing with a life-threatening disease like depression. One of the things that I really like about my current doc is that he agrees with this and is very pragmatic and open-minded. There are other problems that mean I need to leave him, unfortunately.

Years ago, I worked as a medical assistant at a heroin detox center. The doc there was an interesting guy, and interested in addiction and passed on a lot of good info. One thing he told us is that among the reasons for heroin addiction is that for some people it works as a powerful antidepressant and those people are self-medicating. I'm really glad my lifestyle has never taken me any closer than that to heroin, cuz I might be one of those people, and that's sure a complication I don't need in my life.

I'm realizing that my original message was unclear about how much Vicodin I take. I take it PRN, up to 4 times a day, and each time I take it I now take a whole tab- so on really bad (very depressed, labile, desperate, etc.) days I'm taking up to 4 (they are 5/500 codeine/tylenol).

For headaches, when I have a really really horrible headache, I'll take a second tab if the first hasn't dulled the pain after an hour. I keep track of what I take, and am straight with my pdoc about it. He seems certain from my use pattern that my headaches are not being provoked (rebound headaches) by the codeine, which can be a concern. I always had headache problems, and some of the meds I take are probably contributing. But again, I make the choice to take meds to help me want to live life, and deal with the headaches- even if it means another med.

Best of luck to you, and thanks again for responding. I hope your pdoc wakes up on this issue.

Cece

 

Re: vicodin shellie

Posted by reese1 on March 18, 2002, at 16:16:25

In reply to Re: vicodin shellie, posted by Cece on February 20, 2001, at 23:37:17

i hope things are okay with your new pdoc. that's such a pain in the ass having to change no matter what the reasons are. i left a wonderful great psychiatrist/therapist in L.A. i had for three years when i moved to NY. I've been here 15months and I'm on my third going to the fourth.

i'm biopolar 1, add, learning disabilities, fun stuff, been on everything
currently
the new shrink is trying
lamactal and topamax but my insurance who cover the topamax so that's not working out so well

i've always had a strong response to opiates. finally i talked my pdoc into trying buprenex. she was so strange about it. she would actually write me a script for methadone (as an off label anti-depressant) but not for buprenex. she felt that the DEA would be after her because buprenex is not legal for her to write scripts for. So she sent me to some doctor who has advertising in the back of village voice. So i have to see him to get the scripts.

It's been strange. It didn't work at all at first. But i was tapering off huge doses of meds. My lithium, celexa, adderall, risperdal, clonapan, and after 2 weeks i stopped. then after 2 weeks i tried it again and since then i have different reactions each day. One day it takes possibly three hours for me to actually feel it. Then another day an hour. Some times one ampule is enough. Another day it isn't.

anyway i don't know if you'll even get this but i hope you are continiuing to get your script for the vicodin.

 

Re: vicodin shellie » reese1

Posted by Zo on March 21, 2002, at 15:06:34

In reply to Re: vicodin shellie, posted by reese1 on March 18, 2002, at 16:16:25

> she felt that the DEA would be after her because buprenex is not legal for her to write scripts for.

Untrue. WHY do they do this. Grrrr.

Zo


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