![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 14 to 38 of 38. Go back in thread:
Posted by shelliR on March 10, 2002, at 9:55:11
In reply to chronic pain -- it's baaaak, posted by Elizabeth on March 9, 2002, at 2:25:20
Posted by Annie Z. on March 10, 2002, at 14:14:50
In reply to chronic pain -- it's baaaak, posted by Elizabeth on March 9, 2002, at 2:25:20
Elizabeth,
Before I found relief, I suffered from myofascial pain in my wrists, my forearms and upper arms for about a year (and intermittently before my year-long struggle). I went to a Rheumatologist, tried physical therapy, and tried to take strong NSAIDs. Everything worked somewhat, but I was still very disabled. Cleaning, typing and even rolling the grocery cart around in the store, all hurt.
Finally, I tried SAMe (S-adenosylmethionine). After about three days on two, 200-mg pills, my pain was almost completely gone. Shortly thereafter, my pain disappeared completely, and I never had pain in my arms again -- that is, until I stopped taking the SAMe. I tried to stop SAMe, and my pain returned, as painful and annoying as it was before. (By the way, after I started the True Hope supplement (about 28 pills/day), I no longer needed to take the SAMe, but this is another story.)
SAMe has been shown in several published studies to be specifically effective as a therapy to reduce the chronic pain associated with fibromyalgia. Please see the journal article that follows.
Unfortunately, as you probably know, SAMe is very expensive. Also, a lot of the companies that make SAMe do not put the labeled dose in their product. In fact, you are a lot more likely to be ripped off in buying SAMe than in most other supplements. For this reason, to get a reliable source of SAMe is imperative. I bought my SAMe from the “Life Extension Foundation, (LEF),” because I believe they are very professional and, I think, a non-profit foundation. They have an independent lab, which evaluates all of their products.
As far as the price, you can buy 200 200-mg pills from LEF for about $43. 400 to 800 mg of SAMe is the is the dose for SAMe that LEF suggests. That will run you about one dollar to two dollars per day. I only needed to take 400 mg of SAMe.
I hope you try this strategy, because I think our diagnoses are similar; and this may very well help you.
Annie Z.
Evaluation of S-adenosylmethionine in primary fibromyalgia. A double-blind crossover study
Tavoni A, Vitali C, Bombardieri S, Pasero G
Institute of Medical Pathology I, University of Pisa, Italy.
Am J Med 1987 Nov 20;83(5A):107-10
The effect of S-adenosylmethionine (SAMe) and placebo was evaluated in a short-term crossover study of 17 patients with primary fibromyalgia. Eleven of 17 patients had a significant depressive state as assessed by either the Hamilton Depression Rating Scale or the Scala di Autovalutazione per la Depressione (SAD) rating scale. The number of trigger points plus painful anatomic sites decreased after administration of SAMe (p < 0.02) but not after placebo treatment. In addition, scores on both the Hamilton and SAD rating scales improved after SAMe administration (p < 0.05 and p < 0.005, respectively), whereas they did not significantly change after placebo treatment. In all the patients, there was a good correlation between scores on the Hamilton rating scale and the number of trigger points. Thus, this preliminary study confirms the close relationship between primary fibromyalgia and psychologic disturbances, particularly with regards to a depressive state. SAMe treatment, by improving the depressive state and reducing the number of trigger points, seems to be an effective and safe therapy in the management of primary fibromyalgia.
Posted by BarbaraCat on March 10, 2002, at 17:12:24
In reply to chronic pain -- it's baaaak, posted by Elizabeth on March 9, 2002, at 2:25:20
Yo Elizabeth,
Wecome back! Wondered where you were and if you were OK. I'm glad it's 'only' physical rather than emotional pain (although I'm only too aware of how one can cause the other). I haven't tried prolotherapy, but a few friends have and have reported great results. It may be paid for by insurance. The website is www.prolotherapy.com.If you can find a warm water pool, hydrotherapy exercises can help alot. Also, regular stretching done in a hot tub. I have a bad case of fibromyalgia and agree wholeheartedly with IsoM. Movements to keep limber are essential and flowing dance seems to help me out the most. Of course, I say this as I'm getting ready to crawl back into bed at 3:00 pm. Hey, it's a rainy Sunday, I hurt, and I just don't wanna!! I'll keep you in my thoughts. - Barbara
Posted by Triss on March 10, 2002, at 20:04:34
In reply to chronic pain -- it's baaaak, posted by Elizabeth on March 9, 2002, at 2:25:20
>[...]
> The reason I haven't been posting much lately is because my back-neck-shoulder pain has flared up again after having been dormant for quite some time. As a result, typing is something I can only do for a very short time. I've mostly limited myself to checking email, but I haven't even been very good about that. So if you posted something directed at me, or sent me an email and I haven't yet written back, you have my apologies -- I'm not just ignoring you! (I'm ignoring *everything*!)
>[...]Hope your chronic pain problem gets better soon (so you can resume posting 'fully' again... <g>). I've personally found you're contributions to this forum to be quite valuable, as they are, both, objectively informed as well as very helpful on the subjective/personal level (a rare combination). But, my appreciation of your messages aside, and of course more important to be sure, take care of yourself.
Take care,
Triss
Posted by shelliR on March 11, 2002, at 19:12:42
In reply to chronic pain -- it's baaaak, posted by Elizabeth on March 9, 2002, at 2:25:20
Hi Elizabeth,
I hope you are still checking in even though it is hard to write.
My father just called me to tell me he was sending me an article about pain from some MS association that he donates money to. He said it was not directly related to pain and MS, but all pain.
Both my parents were dead set again me taking bupe or any opiate again, although I told them I couldn't stand to live with my pain. Anyway, my dad must have let his mind open a little to send me this article because it talks about how the director of a pain center at NIH (I think a Dr. Berger) is of the opinion that a person should not suffer chonic pain, even if it means they take opiates. But she also says that the person must work with a person or clinic that understands the use of opiates; even oxycontin is not "bad" if it is used properly.
So I was just wondering about the pain you are suffering, and whether something for pain would help you. I know it is best to use other alternatives first, but maybe increasing the buprenorphine might help your pain.
Even though I am able to get bupe via the internet, I miss the support of a doctor. I am finally realizing from the advice and Judy and others that I might be better off going the pain route instead of the pdoc route. I realize that your situation is different, but I hope you explore *everything* that might give you relief for your pain.
Take care,
Shelli
Posted by BarbaraCat on March 11, 2002, at 23:26:27
In reply to Re: chronic pain -- it's baaaak » Elizabeth, posted by shelliR on March 11, 2002, at 19:12:42
Shelli,
If the article has an internet URL, I'd be interested in getting it. I have fibromyalgia which is sometimes very severe. It's concomittant with the depression, and sometimes one outweighs the other, however, I don't feel my pain is being addressed sufficiently by my primary care doc. Also, you mentioned you're able to get bupe from the internet. I know the policy on this site regarding posting overseas drug url's, however, maybe posting the country won't be such a no-no. I could do some research on my own, try it, and then report back to my doc if it's a winner. I take hydrocodone when the pain gets bad. Is bupe all that much different from hydro? Another question: does it cause constipation? That aspect of the hydro is literally a pain in the a**.- Barbara
Posted by shelliR on March 15, 2002, at 21:59:23
In reply to Chronic Pain » shelliR, posted by BarbaraCat on March 11, 2002, at 23:26:27
Hi Barbara,
To attempt to answer your questions:
Buprenorphine is a partial opiate, but it does not feel all that different to me than hydrocodone. I assume there must be a major difference since they are close to approving bupe as appropriate for detox (and not hydro).
Bupe is also constipating. But as I told Elizabeth in another post, putting 1/4 a day of ground flax in yogurt completely takes care of that problem for me. If you try it, buy a little electric coffee grinder (about $10), and grind it just before you eat it.
My father sent me the article on pain. I don't see a URL, but they give two useful URLs on pain which I found very helpful:
www.ampainsoc.org
www.aapainmanage.org
Anyway, I’m going to start a post below on pain and opiates/habituation vs addiction below.
The person they interview is Dr. Ann Berger, chief of pain and palliative care services at the Clinc Center at NIH.Take care,
Shelli
Posted by cisco on March 21, 2002, at 15:11:49
In reply to Re: chronic pain, posted by Elizabeth on March 9, 2002, at 16:52:19
Hey Liz Beth:
Have U tried increasing the Buppy Morphine?
Disregarding cost for a moment, Can palliation be achieved with a substantial (2x, 4x or more) dose increase? You are currently taking 300ug, 3x times a day? That is a fairly low dose, IMHO.Hope you feel bettah!
Posted by Elizabeth on March 22, 2002, at 18:33:00
In reply to Re: chronic pain - More Bup?, posted by cisco on March 21, 2002, at 15:11:49
> Hey Liz Beth:
I'm neither a "Liz" nor a "Beth," much less both! :-)
> Have U tried increasing the Buppy Morphine?
Does "buppy" rhyme with "puppy?"
Seriously -- there's supposed to be a ceiling effect with buprenorphine (as it is a partial agonist), but nobody seems to know where the ceiling is in humans. But using opioids for chronic pain can be tricky. I'd prefer not to go down that road; I think that my pain could be managed with muscle relaxants (Soma, benzos).
My mdoc has me taking a NSAID (diclofenac, brand name Voltaren) thrice daily, as opposed to just "as-needed." He says that it may work better if used regularly, so I thought it'd be worth a try. I ran out of Xanax because I was using it for the muscle tension. I should have asked him (my mdoc, that is) for a new script when I saw him, but it didn't occur to me, and now I'm just out and I can't reach my pdoc (my next appt with her isn't until 4/16).
> Disregarding cost for a moment, Can palliation be achieved with a substantial (2x, 4x or more) dose increase? You are currently taking 300ug, 3x times a day? That is a fairly low dose, IMHO.
It's a reasonable amount; 0.3 mg of buprenorphine is supposed to be equivalent to 10 mg morphine (the equivalent PO dose would be about 30 mg, I think). The maximum recommended amount of buprenorphine to be given in any single dose is 0.6 mg, and it's recommended that this dose only be used occasionally, not regularly. (Addicts need much higher doses for maintenance, of course, but that's a very different situation.)
-elizabeth
Posted by shelliR on March 22, 2002, at 19:21:12
In reply to Re: buprenorphine for chronic pain? » cisco, posted by Elizabeth on March 22, 2002, at 18:33:00
It's a reasonable amount; 0.3 mg of buprenorphine is supposed to be equivalent to 10 mg morphine (the equivalent PO dose would be about 30 mg, I think). The maximum recommended amount of buprenorphine to be given in any single dose is 0.6 mg, and it's recommended that this dose only be used occasionally, not regularly. (Addicts need much higher doses for maintenance, of course, but that's a very different situation.)
-elizabeth
Elizabeth,
We have determined on the board that I am not an addict. Yet I have been taking .8mg regularly at one time, then usually about .6 mg later (but I also have bad chest pain mixed in with depression). Also I am taking it sublingually but from what I've read it doesn't make a difference; just takes longer to reach peak dose. I was taking a very high dose of oxycontin then methadone. I think that has affected my reaction to buprenorphine; I also need more vicodin than before. Before oxycontin, the most vicodin I ever took in a day was 7.5mg-never went up in three years. So I think for all intensive purposes I REACT like an addict. Because if heroin didn't change your brain chemistry, I think when addicts switch to bupe as an alternative, they would be able to taper very quickly. I got off of methodone (besides my nightmare hospital experience) quite easily, within a couple a week by decreasing 10mg per day I think. BTW, in Botkin's study, some of the subjects (patients) got up to 3mg a day and he still counted that as a success. So where are you getting the expected maximun dose?Shelli
Posted by cisco on March 22, 2002, at 19:44:45
In reply to Re: buprenorphine for chronic pain? » cisco, posted by Elizabeth on March 22, 2002, at 18:33:00
Dear Elizabeth:
I apologise for playing with your name. No offense intended.
I suppose Buppy is closer to Poopy than Puppy.
Playing with language is an annoying habit of mine.The range of Buprenorphine dosing is so wide - 32mg down to 200ug, seems like there ought to be a little wiggle room in there.
I agree: where is the ceiling? Might be a big house....
Also, if Kappa agonism is dysphoric, what is the effect of Bup's potent Kappa antagonism?
The NSAIDS create an interesting nociceptive synergy with opioids in the brain. Hope they help you.
I was offering my $0.02 out of concern for your pain, and my interest in this unique Opioid. Nothing more, nothing less.
Take care,
Cisco
Posted by cisco on March 22, 2002, at 20:06:51
In reply to Re: buprenorphine for chronic pain? » Elizabeth, posted by shelliR on March 22, 2002, at 19:21:12
Dear shelliR:
I am currently taking 0.4mg of Buprenorphine, about 5x a day. However, instead of taking the tabs sublingually, as indicated, I am instead crushing them, and insufflating (snorting) the resultant fine powder. LOL!
Amazingly, the Bup works almost immediately, and IMHO, it is considerably stronger than when taken sublingually.
Perhaps it's because the nasal mucosa is closer to the brain, or there is more complete absorption, and no waste.
Yes, it looks suspicious snorting lines of white powder. LMAO! However, since I discovered the 'virtue' of snorting Bup, I have yet to waste another dose via the SL route!
My research continues....
Cisco
Posted by shelliR on March 22, 2002, at 20:17:17
In reply to Re: buprenorphine for chronic pain?, posted by cisco on March 22, 2002, at 20:06:51
Cisco,
Thanks for the advise. But 5x a day? They last about 6 hours for me. BTW, the reason "addicts" can take it once a day IS because their dose is so high. One of the guys who did the bup/depression study in Boston told me that the more you take, the longer it lasts. I've never snorted anything, but maybe I'll try it.
Shelli
p.s, my two overseas sources are out of bup, so I'll getting a bit nervous. I suppose if things get horrible, I can always go to a methadone clinic. How many do you usually order at once? I beginning to think I should order much more at a time so I don't get so nervous.
Dr. Bob, this is not a where do you get it question.
Posted by cisco on March 22, 2002, at 20:35:40
In reply to Re: buprenorphine for chronic pain? » cisco, posted by shelliR on March 22, 2002, at 20:17:17
Hi shelliR:
Good question: Was taking Oxycontin, so I'm taking it 5x a day, to guarantee a smooth transition, in the hope of finding something of a 'ceiling' effect, and because it actually gives me a noticeable boost!
Try it 'Intranasaly' - I think you will be pleasantly surprised! I was getting fed up and claustrophobic with the sublingual method: holding the tab under my tongue for 10 minutes w/o swallowing. What do you have to lose? And everything to gain (including grey boogers)!
I purchase 100 at a time. Cost $0.76 each for the Siam Pharmaceutical generic, which is equal to, or stronger than the Temgesic from Schering/Plough. In stock, but the OP limits orders to 100 generic, and 50 Brand name, per week. I want to have a stockpile of about 3 months, then re-evaluate my situation/need down the road apace.
Cisco
Posted by Elizabeth on March 23, 2002, at 13:43:30
In reply to Re: buprenorphine for chronic pain? » Elizabeth, posted by shelliR on March 22, 2002, at 19:21:12
Shelli,
0.6 mg is the max recommended dose (in a single dose, not per day) for *pain*, but that's just because it hasn't been studied in higher doses. (I got this from the monograph.) You've got an excellent point: there aren't any established dose recommendations for depression. Of course, tolerance is an issue with pain as well; I don't think the monograph even mentioned that.
I'd be surprised if the effective sublingual dose (again, any single dose) wasn't higher than the effective IM dose for any particular person. Have you ever determined what dose you'd need if you were taking it IM?
I think you're right that your previous use of methadone and oxycodone may have had a lasting effect on your tolerance.
FWIW, addicts who switch to buprenorphine *can* taper rapidly. The problem is that they then (also rapidly) go back to heroin.
-elizabeth
p.s. You said you're having trouble getting buprenorphine from overseas? I'm having trouble getting it from the U.S. -- the pharmacy orders it, but the wholesaler doesn't have it (or doesn't have enough of it). I've heard there are a lot of drug shortages lately (at the manufacturer level). I hope this isn't one of them.
Posted by Elizabeth on March 23, 2002, at 13:53:39
In reply to Re: buprenorphine for chronic pain?, posted by cisco on March 22, 2002, at 19:44:45
> I apologise for playing with your name. No offense intended.
No prob. :-)
> I suppose Buppy is closer to Poopy than Puppy.
> Playing with language is an annoying habit of mine.I think it's funny, actually.
> Also, if Kappa agonism is dysphoric, what is the effect of Bup's potent Kappa antagonism?
I don't know. It's an interesting question.
> The NSAIDS create an interesting nociceptive synergy with opioids in the brain. Hope they help you.
No luck so far, but still hoping. Thanks!
-elizabeth
p.s. Snorting the solution is kind of a PITA, but it has at least one advantage over the tabs that you're getting: it's clear! Do those things taste like anything, BTW? The solution is slightly sweet in a mild, inoffensive way (it's 5% dextrose).
Posted by shelliR on March 23, 2002, at 19:11:39
In reply to Re: buprenorphine for chronic pain? » shelliR, posted by Elizabeth on March 23, 2002, at 13:43:30
> I'd be surprised if the effective sublingual dose (again, any single dose) wasn't higher than the effective IM dose for any particular person. Have you ever determined what dose you'd need if you were taking it IM?I only know that the info that comes with temgesic says after two or three hours (I can't recall), the levels in the body were exactly the same for sublingual and IM. The only difference was when they peaked. BTW, I did try inhaling it this morning and I *was* able to get by with less. I felt like a junkie, though.
> I think you're right that your previous use of methadone and oxycodone may have had a lasting effect on your tolerance.One reason I'd like to sue that bastard. I had asked him after I went up once on oxycontin to try buprenorphine instead, and he said no. With no reason.
> p.s. You said you're having trouble getting buprenorphine from overseas? I'm having trouble getting it from the U.S. -- the pharmacy orders it, but the wholesaler doesn't have it (or doesn't have enough of it). I've heard there are a lot of drug shortages lately (at the manufacturer level). I hope this isn't one of them.
I'm getting very nervous because all the sites I know on the internet are out of it. It can't be coincidence; it must be the manufacturer. ALso they've all been out of the generic for months--that's why it really concerns me that they're out of the name brand. If it's months, I will be in a pretty bad position.
And now I'm wondering even if I can get my pdoc to write a prescription in an emergency, will I be able to get it anyway. He's not saying no yet, but he is absolutely up front saying he is afraid of getting sued. And everyone agrees that even through I take it now, he wouldn't be clear of a suit. I'd better try to get vicodin, just in case.
I don't want to go off it now; I'm just starting to catch up on work and I don't want to go to the land of living hell again. I'm up to 250mg of lamictal; I know it will take at least 400mg for me to feel anything and maybe more.Shelli
Posted by cisco on March 24, 2002, at 18:45:28
In reply to Re: buprenorphine for chronic pain? » Elizabeth, posted by shelliR on March 23, 2002, at 19:11:39
Dear shelliR:
There is something I would like to tell you regarding Bup, that is not appropriate to post her. LOL!
Later,
Cisco
Posted by cisco on March 24, 2002, at 19:08:18
In reply to Re: buprenorphine for chronic pain? » cisco, posted by Elizabeth on March 23, 2002, at 13:53:39
Elizabeth:
I spent a while on the Web looking for an explanation of the effects of Antagonism at the Kappa receptor: No explanation so far. It dosen't seem to be a very high priority in the massive research taking place. Everyone's trying to find a powerful analgesic without the 'Bad' side-effects: Euphoria & respiratory depression....
The Bup Tabs I have are from Siam Pharmaceuticals (Thailand). A lttle smaller than the Temgesic from Schering-Plough (both are tiny). I prefer them to the Temgesic. They seem stronger.
Both the Siam and Temgesic are mildly sweet tasting as well. And neither burn my nose at all when snorting them!Cisco
Posted by Dr. Bob on March 25, 2002, at 3:34:35
In reply to Re: buprenorphine for chronic pain?shelliR, posted by cisco on March 24, 2002, at 18:45:28
> There is something I would like to tell you regarding Bup, that is not appropriate to post her.
Hmm, if it's what I think it is, it's not appropriate to use this site to post your email address to exchange that information that way, either...
Bob
PS: Follow-ups about posting policies should be redirected to Psycho-Babble Administration, thanks.
Posted by Zo on March 25, 2002, at 6:01:20
In reply to Re: not appropriate to post, posted by Dr. Bob on March 25, 2002, at 3:34:35
Posted by Zo on March 26, 2002, at 16:41:23
In reply to Re: buprenorphine for chronic pain? » cisco, posted by Elizabeth on March 22, 2002, at 18:33:00
Elizabeth,
Sorry to be so long in posting--where you at with your pain? I might have some ideas. .. nd am real sorry to hear about it.
Zo
Posted by Elizabeth on March 26, 2002, at 21:13:55
In reply to Re: buprenorphine for chronic pain? » Elizabeth, posted by shelliR on March 23, 2002, at 19:11:39
> I only know that the info that comes with temgesic says after two or three hours (I can't recall), the levels in the body were exactly the same for sublingual and IM.
Was the maximum effect the same with the same dose taken by the two different routes?
> BTW, I did try inhaling it this morning and I *was* able to get by with less. I felt like a junkie, though.
Heh. Get used to it! (At least you don't have to go into a pharmacy. Those guys make you feel like a junkie just for having a prescription for Ambien or something. :-) )
> > I think you're right that your previous use of methadone and oxycodone may have had a lasting effect on your tolerance.
>
> One reason I'd like to sue that bastard. I had asked him after I went up once on oxycontin to try buprenorphine instead, and he said no. With no reason.That's awful. Your doctor owes you a reason for anything he wants you to do -- it's your body, not his.
> I'm getting very nervous because all the sites I know on the internet are out of it. It can't be coincidence; it must be the manufacturer.
S**t.
> ALso they've all been out of the generic for months--that's why it really concerns me that they're out of the name brand. If it's months, I will be in a pretty bad position.
I would too. I can manage for a couple days with just the Effexor (tried it recently), but my energy is low and my thoughts aren't very clear. I definitely couldn't function adequately without buprenorphine.
> And now I'm wondering even if I can get my pdoc to write a prescription in an emergency, will I be able to get it anyway. He's not saying no yet, but he is absolutely up front saying he is afraid of getting sued.
I don't understand that, although it's a good sign that he's up-front about it.
> And everyone agrees that even through I take it now, he wouldn't be clear of a suit.
Sure, if he did something wrong (like that other guy you were seeing) then he'd be open to a lawsuit. Do you think he would do something wrong, though?
> I don't want to go off it now; I'm just starting to catch up on work and I don't want to go to the land of living hell again.
That's entirely understandable! Doesn't it feel amazing to come out of it, though? Several people I know (including my parents) have said that I came "back to life" when I started taking it.
> I'm up to 250mg of lamictal; I know it will take at least 400mg for me to feel anything and maybe more.
Good luck with that. I think it's important to have something "in the background" along with buprenorphine, to smooth things out.
-elizabeth
Posted by Elizabeth on March 26, 2002, at 21:16:31
In reply to Re: chronic pain? » Elizabeth, posted by Zo on March 26, 2002, at 16:41:23
> Sorry to be so long in posting--where you at with your pain? I might have some ideas. .. nd am real sorry to hear about it.
I'm finding that I can usually do away with it using a combination of Xanax and relaxation (although my mdoc's ketoprofen idea isn't doing anything). I'm always glad to hear any suggestions or ideas.
-elizabeth
Posted by shelliR on March 28, 2002, at 13:22:56
In reply to Re: buprenorphine for chronic pain? » shelliR, posted by Elizabeth on March 26, 2002, at 21:13:55
Hi Elizabeth,
I am still taking bupe; I keep needing to go up, though. I am going to try to get it from my present pdoc, if he won't then I'll continue looking. Right now I am still titrating up on lamictal, up to 350mg now; am willing to go to 800 if necessary. (Dr. Goldberg mentions this as ceiling dose, anyway.) After that I am thinking about re-trying effexor. First time I threw up, but I can keep trying crumbs, I suppose, until I get used to it. How long til you felt the positive effects of effexor? Do you think that effexor is the most potent AD besides the MAOIs?
> Was the maximum effect the same with the same dose taken by the two different routes?You tell me: "Bruprenorphine is well absorbed in man by the sublingual route, giving plama levels at 2-3 hours after administration which are comparable to those observed at the same time following a similar dose given by the parenteral route. After parenteral administration, plasma concentrations decline in a triexpontial manner, indicating a terminal half-life of about 5 hours. For sublingually administered buprenorphine, peak plasma levels were achieved with 200 minutes, with a systemic absorption half-life of 76 minutes."
can you explain that to me in English?
> > BTW, I did try inhaling it this morning ....
Actually for me it does burn, so I stopped.
> Heh. Get used to it! (At least you don't have to go into a pharmacy. Those guys make you feel like a junkie just for having a prescription for Ambien or something. :-) )
Actually, my pharmacy was not alarmed in any way by the oxycontin, so I suppose buprenorphine won't be a big deal.
> > > I think you're right that your previous use of methadone and oxycodone may have had a lasting effect on your tolerance.I wish so much that I had taken buprenorphine instead of oxycontin to start.
I can manage for a couple days with just the Effexor (tried it recently), but my energy is low and my thoughts aren't very clear. I definitely couldn't function adequately without buprenorphine.
I would be in horrible shape. I have a few hydrocodone but not much. I'm wondering if now that I'm up to 350 on lamictal, when I can start titrating faster. I might ask dr. goldberg in an e-mail. Btw, did you ever contact a Donald Klein, at New York State Psychiatric Institute in NYC? His name has been given to me by several pdocs who would not take me on.
> Sure, if he did something wrong (like that other guy you were seeing) then he'd be open to a lawsuit. Do you think he would do something wrong, though?I don't know what it means to do something wrong, except to let me go off cold turkey. And I don't think he's as pompous as the last guy. Of course, I don't think anyone's as pompous as the that pdoc.
>
> > I don't want to go off it now; I'm just starting to catch up on work and I don't want to go to the land of living hell again.
>
> That's entirely understandable! Doesn't it feel amazing to come out of it, though? Several people I know (including my parents) have said that I came "back to life" when I started taking it.On .6mg twice a day now, I am only half-way into "back to life" At first, with a way lower dose, I was fully here. I am quite discouraged.
I'm glad that your depressive days seem to be over.
Shelli
This is the end of the thread.
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