Psycho-Babble Medication Thread 6225

Shown: posts 1 to 14 of 14. This is the beginning of the thread.

 

Naltrexone (ReVia) updates

Posted by chuck on May 18, 1999, at 12:45:39

I've read many of the entries regarding naltrexone (most recently those under the 'Dysthymis/Treatment Resistant Depressions' thread), and i suppose i'd like to hear from other people with nal experience, as well as from those who've experienced some change in its effectivness, or ineff-- i started taking naltrexone about four weks ago in conjunction with Zoloft, which i've taken for most of the last 4+ years, but without the sort of effect that wayne describes. i've been depressed again for so long that i'm begining to think there's nothing else but this. life without Z is certainly much worse, but oh how i long for those magical days (500 maybe) when i first took zoloft and life was fantastic, felt alive for the first time...ever? Please, tell me your naltrexone stories!
Give me your naltrexone updates!
thanks---chuck

 

Re: Naltrexone (ReVia) updates

Posted by Peter on May 18, 1999, at 14:52:37

In reply to Naltrexone (ReVia) updates, posted by chuck on May 18, 1999, at 12:45:39

Hi Chuck,
I tried Naltrexone with both Prozac and Celexa (4 weeks) and did not notice any positive (or negative) effects. When I started Prozac many years ago, I had the experience of an epiphany and then it gradually began to lose its effectiveness. Since then I have been on so many meds that I have almost lost track. I am beginning to lose all hope of ever finding something that works. I am thinking of trying Buprenorphine and I would be interested in anyone who has had good or bad experiences with this med. Thanks. Peter

 

buprenorphine - Peter

Posted by Elizabeth on May 18, 1999, at 19:54:37

In reply to Re: Naltrexone (ReVia) updates, posted by Peter on May 18, 1999, at 14:52:37

Peter,

It worked very well for me, but I could not tolerate the side effects. I still take it "as needed" but only rarely.

I took it for 6 weeks or so and didn't develop any tolerance. I also tried morphine but found that it didn't work as well.

What else have you tried?

 

Re: buprenorphine experience

Posted by Jim Hardy on May 18, 1999, at 23:22:05

In reply to Re: Naltrexone (ReVia) updates, posted by Peter on May 18, 1999, at 14:52:37

> Hi Chuck,
> I tried Naltrexone with both Prozac and Celexa (4 weeks) and did not notice any positive (or negative) effects. When I started Prozac many years ago, I had the experience of an epiphany and then it gradually began to lose its effectiveness. Since then I have been on so many meds that I have almost lost track. I am beginning to lose all hope of ever finding something that works. I am thinking of trying Buprenorphine and I would be interested in anyone who has had good or bad experiences with this med. Thanks. Peter

I've been on it for about six weeks and find it works well except for mood swings when a dose begins to wear off. It seems to have a very marked effect on both my anxiety and depression. It's hard to say whether there is rebound anxiety/depression, though; I haven't really been able to tell. This would be my major concern in taking it, and I really can't answer it. Once I stopped it for three days and had almost unbearable anxiety, but then again I had periods of intense anxiety before I started it. Elizabeth mentioned to me, if I remember correctly, that she felt that there was rebound depression after long term use, and perhaps that's what I was experiencing. There's a web site with info on the drug at http://www.reccolpharm.com/Buprenex/PrescribingInformation/ There's also a report somewhere on the Net on it's use in a research study on refractory depression. I don't know where it is on the web but I can email it to you if you send me your address.

 

Re: buprenorphine experience

Posted by Jim Hardy on May 19, 1999, at 0:00:05

In reply to Re: buprenorphine experience, posted by Jim Hardy on May 18, 1999, at 23:22:05

The study on the use of buprenorphine in depression that I mentioned in my first post can be found at http://www.tiac.net/users/smisch/bupe.html

 

Re: buprenorphine experience

Posted by Peter on May 19, 1999, at 19:29:53

In reply to Re: buprenorphine experience, posted by Jim Hardy on May 19, 1999, at 0:00:05

Jim: thanks for the info! I found the article and am printing it out.

Elizabeth, I can give you a list off the top of my head of the meds I've tried: Prozac, Wellbutrin, Effexor, Serzone, Paxil, St. John's Wort, Zoloft, Celexa, Nortriptyline, and Remeron. Augmentation with Lithium, Cytomel, Synthroid, and Pindolol. There may be more that I'm missing. As I said I have been responsive to Prozac for a 1-2 year period and have had momentary responses to others. This process feels like Chinese Water Torture and I'm starting to lose hope! What about you? It sounds like the buprenorphine is working. How in the world did you get a hold of Morphine? Thanks for your input. Peter

> The study on the use of buprenorphine in depression that I mentioned in my first post can be found at http://www.tiac.net/users/smisch/bupe.html

 

more opiate URLs - Peter

Posted by Jim Hardy on May 19, 1999, at 20:58:36

In reply to Re: buprenorphine experience, posted by Peter on May 19, 1999, at 19:29:53

Peter,

Elizabeth sent me the following URL this morning which has some very good articles on the use of opiates in psychiatric disorders: http://www.geocities.com/HotSprings/9740/medarticlemenu.html
I thought the article at http://www.geocities.com/HotSprings/9740/antimanicevidence.html was especially interesting, because apparently panic anxiety can be a symptom of opiate withdrawal, and I wonder if this is what I was experiencing when I stopped the buprenorphine for a few days. I don't know -- I felt anxious beforehand, too -- but I'm not a doctor and don't want to advocate for one drug or another. It definitely gets rid of my anxiety and panic when I'm taking it. Whether I'm going to pay a price down the line in terms of addiction is too early to tell. I didn't experience any physical WD symptom when I stopped it for three days, but Elizabeth told me that it could take a couple weeks for these to appear, and at any rate, from what I've read, the phsysical WD symptoms are mild. My main concern is rebound anxiety, especially the panicky type mentioned in this article. I just want to send you all this so you're aware of what you're getting into, if you decide to use it. I'm not a doctor. I can just tell you my personal experience, which is that when I take it, it works great, but within five hours or so, when it begins to wear off, I feel bad again, and if I go without it, I feel awful. Whether I'd feel less awful if I'd never taken it at all is what I'm not sure of, but I'd keep the possibility in mind. Anyway, good luck, whatever you decide to do.

 

Re: buprenorphine experience

Posted by Elizabeth on May 20, 1999, at 4:27:40

In reply to Re: buprenorphine experience, posted by Peter on May 19, 1999, at 19:29:53

Here are some less radical ideas:
-Buspar (by itself, in high doses; or as augmentation of an SSRI)
-Lamictal
-MAO inhibitors (Nardil, Parnate)
-desipramine
-tramadol (Ultram)
-stimulants (Ritalin, Cylert, etc.)
-valproate
-lithium (full dose, not augmentation doses)
-I think that SAMe seems worth a shot
-sleep deprivation (alone or in combination with an AD)
-reconsider diagnosis (what *are* you being treated for, anyway? I don't think you mentioned!)

Also, just checking, did you have adequate trials of all the ones you listed? How high were the doses? And all of them were completely ineffective?

What are your symptoms, and how long has this depression lasted?

I asked my doctor if I could try taking a narcotic that came in a sustained-release tablet (oxycodone does as well) because one of the problems I was having with Buprenex was that I had trouble taking the midday dose, and it was wearing off with rather nasty effects. (Not withdrawal symptoms - those tend to be *delayed*, and actually I didn't experience any - but relapse of my depression.) So he had me try MS Contin. I didn't find it worked very well and wasn't willing to push the dose up too high due to side effects.

 

has anyone tried Ultram?

Posted by anne on May 20, 1999, at 18:37:37

In reply to Re: buprenorphine experience, posted by Elizabeth on May 20, 1999, at 4:27:40

My doc just added Ultram and I've been doing some reading and see it is an opiate agoinist with norepi and serotonin reuptake inhibition as well. Does this put it the same category as buprenorphine? I haven't taken any yet and am a bit curious about what it will do. We are hoping it won't impair cognition like other drugs I have tried. Any comments about this drup appreciated.

 

Re: buprenorphine experience

Posted by Peter on May 20, 1999, at 19:41:57

In reply to Re: buprenorphine experience, posted by Elizabeth on May 20, 1999, at 4:27:40

> Here are some less radical ideas:
> -Buspar (by itself, in high doses; or as augmentation of an SSRI)
> -Lamictal
> -MAO inhibitors (Nardil, Parnate)
> -desipramine
> -tramadol (Ultram)
> -stimulants (Ritalin, Cylert, etc.)
> -valproate
> -lithium (full dose, not augmentation doses)
> -I think that SAMe seems worth a shot
> -sleep deprivation (alone or in combination with an AD)
> -reconsider diagnosis (what *are* you being treated for, anyway? I don't think you mentioned!)
>
> Also, just checking, did you have adequate trials of all the ones you listed? How high were the doses? And all of them were completely ineffective?
>
> What are your symptoms, and how long has this depression lasted?
>
> I asked my doctor if I could try taking a narcotic that came in a sustained-release tablet (oxycodone does as well) because one of the problems I was having with Buprenex was that I had trouble taking the midday dose, and it was wearing off with rather nasty effects. (Not withdrawal symptoms - those tend to be *delayed*, and actually I didn't experience any - but relapse of my depression.) So he had me try MS Contin. I didn't find it worked very well and wasn't willing to push the dose up too high due to side effects.

Hey Elizabeth, I have been depressed mildly to moderately depressed since the age of 3 or 4. I have had bright spots in my life but they seem to be few and far between. I have already tried Parnate (up to 80 mg I think) and Depakote and SAMe. Parnate seemed to work for a while but effect gradually went away. I had kind of a hypomanic response to Zoloft and Wellbutrin.
Like anne, I am curious about Ultram, what is the tolerance and dependence potential? Studies on its effectiveness with depression? Thanks, Peter

 

Re: has anyone tried Ultram?

Posted by Elizabeth on May 20, 1999, at 21:22:00

In reply to has anyone tried Ultram?, posted by anne on May 20, 1999, at 18:37:37

Anne,

Buprenorphine isn't a monoamine reuptake inhibitor like tramadol is. I did try tramadol and didn't find it as effective as buprenorphine - however, the side effects were much milder.

I didn't find it impaired my cognition or anything like that. Actually I'm a student and these meds make it easier for me to concentrate and focus.

 

more on tramadol - Peter

Posted by Elizabeth on May 20, 1999, at 21:39:39

In reply to Re: buprenorphine experience, posted by Peter on May 20, 1999, at 19:41:57

Yeah, here are a few refs on tramadol:

Markowitz JS, et al.
Venlafaxine-tramadol similarities.
Med Hypotheses. 1998 Aug;51(2):167-8.

Rojas-Corrales MO, et al.
Tramadol induces antidepressant-type effects in mice.
Life Sci. 1998;63(12):PL175-80.

Also:

Bono AV, et al.
[Effectiveness and tolerance of tramadol in cancer pain. A comparative study with respect to buprenorphine].
Drugs. 1997;53 Suppl 2:40-9. French.

Goldsmith TB, et al.
Rapid remission of OCD with tramadol hydrochloride.
Am J Psychiatry. 1999 Apr;156(4):660-1.

Shapira NA, et al.
Open-label pilot study of tramadol hydrochloride in treatment-refractory obsessive-compulsive disorder.
Depress Anxiety. 1997;6(4):170-3.

I should also mention that because of its monoamine reuptake inhibition activity, tramadol must not be used with an MAO inhibitor and probably should not be used with SSRIs either (there have been some reports of serotonin syndrome with this combination).

It's an option, although I think that Nardil would probably be a better choice since Parnate worked initially. Sometimes you need to use aggressive dosing and augmentation with those.

Also, if you had hypomania on antidepressants, that suggests that maybe a mood stabilizer like Lamictal or full-dose lithium would benefit you. They sometimes take a while to produce results for dysthymia, but the results are robust.

Can I ask if you have any symptoms other than depressed mood?

 

Re: more on tramadol - cautions

Posted by Dr. Bob on May 21, 1999, at 9:18:07

In reply to more on tramadol - Peter, posted by Elizabeth on May 20, 1999, at 21:39:39

Hi,

It wouldn't hurt to check Psychopharmacology Tips (do a search for "tramadol") before taking it.

Good luck,

Bob

 

Re: more on tramadol - cautions

Posted by Elizabeth on May 21, 1999, at 20:45:19

In reply to Re: more on tramadol - cautions, posted by Dr. Bob on May 21, 1999, at 9:18:07

It's possible to become addicted to tramadol if you abuse it. This is probably true of buprenorphine as well. (I have trouble imagining this, but then I've never taken enough of a narcotic to cause "euphoria" so I have no idea how good it is. :-)

On the other hand, almost anything can be addictive if abused. I've even come across references to MAOI addiction! (I kid you not.)


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